How much rates vary
Facilitymedian $2,399 · 10th to 90th $871 to $5,888Professionalmedian $646 · 10th to 90th $380 to $977
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 $478.63 Median $549.54 Typical High $707.95 | Professional | None | $478.63 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $537.03 | Professional | 54 · Surgery only | $363.08 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $107.15 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $70.79 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $758.58 | Professional | None | $371.54 | $549.54 | $758.58 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $316.23 Typical High $446.68 | Professional | 54 · Surgery only | $208.93 | $316.23 | $446.68 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $95.50 Typical High $134.90 | Professional | 55 · Aftercare only | $64.57 | $95.50 | $134.90 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $45.71 Typical High $64.57 | Professional | 56 · Pre-op care only | $30.90 | $45.71 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $3,090.30 | Facility | None | $676.08 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $977.24 | Professional | None | $645.65 | $741.31 | $977.24 |
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 $309.03 Median $501.19 Typical High $891.25 | Professional | None | $309.03 | $501.19 | $891.25 |
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 $239.88 Median $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $239.88 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $95.50 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $501.19 |
Where Rhode Island sits
The same service costs 4.7 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 $6,438MT $1,383
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.