How much rates vary
Facilitymedian $955 · 10th to 90th $112 to $3,890Professionalmedian $575 · 10th to 90th $398 to $851
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 $1,513.56 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,513.56 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $575.44 | Professional | None | $512.86 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $426.58 | Professional | 54 · Surgery only | $389.05 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $57.54 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $57.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $794.33 | Professional | None | $407.38 | $524.81 | $794.33 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $309.03 Typical High $398.11 | Professional | 54 · Surgery only | $257.04 | $309.03 | $398.11 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $123.03 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $123.03 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $44.67 Typical High $58.88 | Professional | 56 · Pre-op care only | $37.15 | $44.67 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $1,621.81 | Facility | None | $446.68 | $1,148.15 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $870.96 | Professional | None | $630.96 | $758.58 | $870.96 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $831.76 | Professional | None | $346.74 | $446.68 | $831.76 |
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 $257.04 Median $281.84 Typical High $288.40 | Professional | 52 · Reduced service | $257.04 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $114.82 | Professional | 53 · Discontinued | $102.33 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $398.11 |
Where Rhode Island sits
The same service costs 5.3 times more in Colorado 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
CO $4,377FL $831
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.