How much rates vary
Facilitymedian $2,042 · 10th to 90th $871 to $5,888Professionalmedian $389 · 10th to 90th $269 to $617
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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $426.58 | Professional | None | $309.03 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $263.03 Typical High $316.23 | Professional | 54 · Surgery only | $234.42 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $53.70 Typical High $63.10 | Professional | 55 · Aftercare only | $46.77 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $35.48 Typical High $42.66 | Professional | 56 · Pre-op care only | $30.90 | $35.48 | $42.66 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $575.44 | Professional | None | $257.04 | $363.08 | $575.44 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $407.38 | Professional | 54 · Surgery only | $169.82 | $239.88 | $407.38 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $30.20 Typical High $51.29 | Professional | 55 · Aftercare only | $20.89 | $30.20 | $51.29 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.20 Typical High $51.29 | Professional | 56 · Pre-op care only | $20.89 | $30.20 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,621.81 Typical High $2,344.23 | Facility | None | $588.84 | $1,621.81 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $870.96 | Professional | None | $275.42 | $389.05 | $870.96 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $6,456.54 | Facility | None | $870.96 | $2,089.30 | $6,456.54 |
United Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $724.44 | Professional | None | $257.04 | $398.11 | $724.44 |
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 $154.88 Median $177.83 Typical High $213.80 | Professional | 52 · Reduced service | $154.88 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $70.79 Typical High $85.11 | Professional | 53 · Discontinued | $61.66 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $245.47 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $218.78 | $245.47 | $295.12 |
Where Rhode Island sits
The same service costs 6.1 times more in Colorado 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
CO $6,346MT $1,043
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.