How much rates vary
Facilitymedian $251 · 10th to 90th $112 to $3,890Professionalmedian $339 · 10th to 90th $245 to $513
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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $407.38 | Professional | None | $316.23 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $234.42 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $46.77 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $33.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $489.78 | Professional | None | $257.04 | $331.13 | $489.78 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $194.98 Typical High $251.19 | Professional | 54 · Surgery only | $158.49 | $194.98 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $58.88 Typical High $75.86 | Professional | 55 · Aftercare only | $48.98 | $58.88 | $75.86 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.18 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $28.18 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $1,202.26 | Facility | None | $162.18 | $218.78 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $549.54 | Professional | None | $389.05 | $467.74 | $549.54 |
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 $213.80 Median $269.15 Typical High $501.19 | Professional | None | $213.80 | $269.15 | $501.19 |
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 $158.49 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $63.10 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $239.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $218.78 | $239.88 | $239.88 |
Where Rhode Island sits
The same service costs 6.4 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 $2,602FL $408
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.