How much rates vary
Facilitymedian $1,413 · 10th to 90th $646 to $4,898Professionalmedian $398 · 10th to 90th $295 to $575
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 $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $537.03 | Professional | None | $295.12 | $398.11 | $537.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $190.55 | $234.42 | $275.42 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $58.88 | $70.79 | $83.18 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $27.54 | $33.88 | $39.81 |
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 $446.68 Median $575.44 Typical High $645.65 | Professional | None | $446.68 | $575.44 | $645.65 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $602.56 | Professional | None | $263.03 | $331.13 | $602.56 |
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 $194.98 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $275.42 |
Where Rhode Island sits
The same service costs 4.6 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 $4,822MT $1,050
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.