How much rates vary
Facilitymedian $3,802 · 10th to 90th $933 to $10,233Professionalmedian $977 · 10th to 90th $676 to $1,318
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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,288.25 | Professional | None | $676.08 | $891.25 | $1,288.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $616.60 | Professional | 54 · Surgery only | $436.52 | $524.81 | $616.60 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $162.18 Typical High $190.55 | Professional | 55 · Aftercare only | $131.83 | $162.18 | $190.55 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,786.30 Typical High $6,918.31 | Facility | None | $831.76 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,318.26 | $1,548.82 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,380.38 | Professional | None | $616.60 | $851.14 | $1,380.38 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Where Rhode Island sits
The same service costs 5.7 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 $13,613MT $2,377
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.