How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,230 to $10,233Professionalmedian $1,288 · 10th to 90th $1,023 to $1,820
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,715.35 Median $3,981.07 Typical High $5,495.41 | Facility | None | $3,715.35 | $3,981.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $2,137.96 | Professional | None | $912.01 | $1,230.27 | $2,137.96 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $812.83 Typical High $1,445.44 | Professional | 54 · Surgery only | $575.44 | $812.83 | $1,445.44 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $144.54 Typical High $257.04 | Professional | 55 · Aftercare only | $102.33 | $144.54 | $257.04 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $72.44 Typical High $125.89 | Professional | 56 · Pre-op care only | $51.29 | $72.44 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,981.07 Typical High $5,623.41 | Facility | None | $1,318.26 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,698.24 | $2,187.76 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,819.70 | Professional | None | $933.25 | $1,122.02 | $1,819.70 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $891.25 |
Where Rhode Island sits
The same service costs 3.6 times more in Alaska than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $11,248MT $3,134
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.