How much rates vary
Facilitymedian $3,715 · 10th to 90th $933 to $10,233Professionalmedian $912 · 10th to 90th $617 to $1,259
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 $891.25 Median $912.01 Typical High $912.01 | Professional | None | $891.25 | $912.01 | $912.01 |
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 $616.60 Median $812.83 Typical High $1,148.15 | Professional | None | $616.60 | $812.83 | $1,148.15 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $478.63 Typical High $562.34 | Professional | 54 · Surgery only | $398.11 | $478.63 | $562.34 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $147.91 Typical High $173.78 | Professional | 55 · Aftercare only | $120.23 | $147.91 | $173.78 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $69.18 Typical High $81.28 | Professional | 56 · Pre-op care only | $57.54 | $69.18 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,165.95 Typical High $8,912.51 | Facility | None | $676.08 | $6,165.95 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,202.26 | $1,445.44 |
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 $549.54 Median $870.96 Typical High $1,258.93 | Professional | None | $549.54 | $870.96 | $1,258.93 |
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 6.4 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 $13,837MT $2,168
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.