How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,023 to $10,471Professionalmedian $955 · 10th to 90th $661 to $1,318
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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,258.93 | Professional | None | $660.69 | $891.25 | $1,258.93 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $524.81 Typical High $616.60 | Professional | 54 · Surgery only | $426.58 | $524.81 | $616.60 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $158.49 Typical High $186.21 | Professional | 55 · Aftercare only | $131.83 | $158.49 | $186.21 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $61.66 | $75.86 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $6,760.83 Typical High $9,772.37 | Facility | None | $831.76 | $6,760.83 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,318.26 | $1,513.56 |
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 $602.56 Median $831.76 Typical High $1,380.38 | Professional | None | $602.56 | $831.76 | $1,380.38 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
Where Rhode Island sits
The same service costs 6.2 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 $14,513MT $2,350
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.