How much rates vary
Facilitymedian $2,399 · 10th to 90th $871 to $5,888Professionalmedian $589 · 10th to 90th $417 to $955
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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $933.25 | Professional | None | $467.74 | $549.54 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | 54 · Surgery only | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $54.95 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $891.25 | Professional | None | $467.74 | $588.84 | $891.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $389.05 Typical High $630.96 | Professional | 54 · Surgery only | $275.42 | $389.05 | $630.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $104.71 Typical High $169.82 | Professional | 55 · Aftercare only | $74.13 | $104.71 | $169.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $54.95 Typical High $89.13 | Professional | 56 · Pre-op care only | $38.90 | $54.95 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,089.30 Typical High $3,019.95 | Facility | None | $676.08 | $2,089.30 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,096.48 | Professional | None | $660.69 | $954.99 | $1,096.48 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $954.99 | Professional | None | $389.05 | $489.78 | $954.99 |
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 $234.42 Median $234.42 Typical High $275.42 | Professional | 52 · Reduced service | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $389.05 |
Where Rhode Island sits
The same service costs 4.7 times more in Vermont 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
VT $7,643MT $1,633
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.