How much rates vary
Facilitymedian $3,715 · 10th to 90th $933 to $10,233Professionalmedian $912 · 10th to 90th $447 to $1,778
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 $851.14 Median $912.01 Typical High $1,096.48 | Professional | None | $851.14 | $912.01 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $2,041.74 | Professional | None | $676.08 | $912.01 | $2,041.74 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $549.54 Typical High $1,230.27 | Professional | 54 · Surgery only | $389.05 | $549.54 | $1,230.27 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $147.91 Typical High $323.59 | Professional | 55 · Aftercare only | $102.33 | $147.91 | $323.59 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $77.62 Typical High $169.82 | Professional | 56 · Pre-op care only | $53.70 | $77.62 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,168.69 Typical High $5,888.44 | Facility | None | $588.84 | $4,168.69 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,230.27 Typical High $2,089.30 | Professional | None | $616.60 | $1,230.27 | $2,089.30 |
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 $389.05 Median $691.83 Typical High $1,778.28 | Professional | None | $389.05 | $691.83 | $1,778.28 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $645.65 |
Where Rhode Island sits
The same service costs 6.0 times more in Colorado than in Hawaii. 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 $12,924HI $2,150
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.