How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,023 to $10,471Professionalmedian $933 · 10th to 90th $646 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 $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $93.33 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,230.27 | Professional | None | $645.65 | $851.14 | $1,230.27 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $501.19 Typical High $588.84 | Professional | 54 · Surgery only | $416.87 | $501.19 | $588.84 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $151.36 Typical High $177.83 | Professional | 55 · Aftercare only | $125.89 | $151.36 | $177.83 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $72.44 Typical High $85.11 | Professional | 56 · Pre-op care only | $60.26 | $72.44 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,309.57 Typical High $9,120.11 | Facility | None | $676.08 | $6,309.57 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,258.93 | $1,445.44 |
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 $588.84 Median $812.83 Typical High $1,318.26 | Professional | None | $588.84 | $812.83 | $1,318.26 |
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 $467.74 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Where Rhode Island sits
The same service costs 6.1 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 $13,882MT $2,270
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.