How much rates vary
Facilitymedian $1,862 · 10th to 90th $871 to $5,888Professionalmedian $407 · 10th to 90th $166 to $661
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 $218.78 Median $489.78 Typical High $660.69 | Professional | None | $218.78 | $489.78 | $660.69 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $549.54 | Professional | None | $141.25 | $223.87 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,258.93 Typical High $1,621.81 | Facility | None | $676.08 | $1,258.93 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $446.68 Typical High $575.44 | Professional | None | $251.19 | $446.68 | $575.44 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $707.95 | Professional | None | $263.03 | $407.38 | $707.95 |
6 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 $245.47 Typical High $331.13 | Professional | 52 · Reduced service | $245.47 | $245.47 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | 53 · Discontinued | $100.00 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $489.78 | Professional | 54 · Surgery only | $371.54 | $371.54 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $97.72 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $457.09 |
Where Rhode Island sits
The same service costs 6.2 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 $4,647MT $748
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.