How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,023 to $10,471Professionalmedian $851 · 10th to 90th $603 to $1,175
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 $831.76 Median $851.14 Typical High $977.24 | Professional | None | $831.76 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,122.02 | Professional | None | $602.56 | $794.33 | $1,122.02 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $467.74 Typical High $549.54 | Professional | 54 · Surgery only | $380.19 | $467.74 | $549.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $141.25 Typical High $165.96 | Professional | 55 · Aftercare only | $117.49 | $141.25 | $165.96 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $79.43 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,165.95 Typical High $8,709.64 | Facility | None | $676.08 | $6,165.95 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,348.96 | Professional | None | $977.24 | $1,174.90 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,570.88 | $12,882.50 |
United Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,230.27 | Professional | None | $537.03 | $724.44 | $1,230.27 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Where Rhode Island sits
The same service costs 6.5 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 $13,795MT $2,119
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.