How much rates vary
Facilitymedian $1,349 · 10th to 90th $389 to $3,981Professionalmedian $537 · 10th to 90th $372 to $794
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 $501.19 Median $537.03 Typical High $537.03 | Professional | None | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $380.19 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $75.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $53.70 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $741.31 | Professional | None | $380.19 | $501.19 | $741.31 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $288.40 Typical High $371.54 | Professional | 54 · Surgery only | $239.88 | $288.40 | $371.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $89.13 Typical High $114.82 | Professional | 55 · Aftercare only | $72.44 | $89.13 | $114.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $42.66 Typical High $53.70 | Professional | 56 · Pre-op care only | $34.67 | $42.66 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,148.15 Typical High $1,621.81 | Facility | None | $588.84 | $1,148.15 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $851.14 | Professional | None | $602.56 | $724.44 | $851.14 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $758.58 | Professional | None | $331.13 | $436.52 | $758.58 |
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 $251.19 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $251.19 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $102.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $354.81 | $380.19 | $380.19 |
Where Rhode Island sits
The same service costs 4.5 times more in Vermont than in Florida. 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 $4,521FL $1,007
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.