How much rates vary
Facilitymedian $2,291 · 10th to 90th $871 to $5,888Professionalmedian $631 · 10th to 90th $372 to $1,000
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 $489.78 Median $588.84 Typical High $758.58 | Professional | None | $489.78 | $588.84 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $436.52 Typical High $575.44 | Professional | 54 · Surgery only | $363.08 | $436.52 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $89.13 Typical High $114.82 | Professional | 55 · Aftercare only | $74.13 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $58.88 Typical High $75.86 | Professional | 56 · Pre-op care only | $48.98 | $58.88 | $75.86 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $794.33 | Professional | None | $346.74 | $537.03 | $794.33 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $302.00 Typical High $436.52 | Professional | 54 · Surgery only | $199.53 | $302.00 | $436.52 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $91.20 Typical High $131.83 | Professional | 55 · Aftercare only | $60.26 | $91.20 | $131.83 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $43.65 Typical High $63.10 | Professional | 56 · Pre-op care only | $28.84 | $43.65 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $3,090.30 | Facility | None | $588.84 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,000.00 | Professional | None | $630.96 | $741.31 | $1,000.00 |
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 $346.74 Median $549.54 Typical High $977.24 | Professional | None | $346.74 | $549.54 | $977.24 |
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 $245.47 Median $295.12 Typical High $380.19 | Professional | 52 · Reduced service | $245.47 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $117.49 Typical High $151.36 | Professional | 53 · Discontinued | $97.72 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $407.38 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $338.84 | $407.38 | $537.03 |
Where Rhode Island sits
The same service costs 4.4 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 $6,451MT $1,460
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.