How much rates vary
Facilitymedian $2,138 · 10th to 90th $794 to $5,888Professionalmedian $380 · 10th to 90th $245 to $490
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 $354.81 Median $380.19 Typical High $416.87 | Professional | None | $354.81 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.02 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $489.78 | Professional | None | $245.47 | $323.59 | $489.78 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $181.97 | $223.87 | $263.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $27.54 Typical High $32.36 | Professional | 55 · Aftercare only | $22.91 | $27.54 | $32.36 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $27.54 Typical High $32.36 | Professional | 56 · Pre-op care only | $22.91 | $27.54 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,137.96 Typical High $3,090.30 | Facility | None | $446.68 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $562.34 | Professional | None | $457.09 | $489.78 | $562.34 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,244.36 | Facility | None | $870.96 | $2,089.30 | $7,244.36 |
United Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $524.81 | Professional | None | $229.09 | $338.84 | $524.81 |
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 $190.55 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $263.03 |
Where Rhode Island sits
The same service costs 7.3 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 $6,269MT $863
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.