How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,023 to $10,471Professionalmedian $1,096 · 10th to 90th $794 to $1,585
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 $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,096.48 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,445.44 | Professional | None | $794.33 | $1,047.13 | $1,445.44 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $501.19 | $616.60 | $724.44 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $154.88 | $186.21 | $218.78 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $74.13 | $89.13 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,309.57 Typical High $8,912.51 | Facility | None | $676.08 | $6,309.57 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,584.89 | $1,778.28 |
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 $707.95 Median $954.99 Typical High $1,621.81 | Professional | None | $707.95 | $954.99 | $1,621.81 |
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 $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $776.25 |
Where Rhode Island sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.