How much rates vary
Facilitymedian $2,291 · 10th to 90th $871 to $5,888Professionalmedian $575 · 10th to 90th $347 to $871
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 $426.58 Median $478.63 Typical High $616.60 | Professional | None | $426.58 | $478.63 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $363.08 Typical High $457.09 | Professional | 54 · Surgery only | $316.23 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $72.44 Typical High $91.20 | Professional | 55 · Aftercare only | $63.10 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $47.86 Typical High $61.66 | Professional | 56 · Pre-op care only | $42.66 | $47.86 | $61.66 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $691.83 | Professional | None | $338.84 | $489.78 | $691.83 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $281.84 Typical High $398.11 | Professional | 54 · Surgery only | $190.55 | $281.84 | $398.11 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $85.11 Typical High $123.03 | Professional | 55 · Aftercare only | $58.88 | $85.11 | $123.03 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $40.74 Typical High $57.54 | Professional | 56 · Pre-op care only | $27.54 | $40.74 | $57.54 |
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 $575.44 Median $676.08 Typical High $870.96 | Professional | None | $575.44 | $676.08 | $870.96 |
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 $281.84 Median $446.68 Typical High $794.33 | Professional | None | $281.84 | $446.68 | $794.33 |
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 $213.80 Median $239.88 Typical High $302.00 | Professional | 52 · Reduced service | $213.80 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $95.50 Typical High $123.03 | Professional | 53 · Discontinued | $85.11 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $338.84 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $295.12 | $338.84 | $426.58 |
Where Rhode Island sits
The same service costs 5.3 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 $6,378MT $1,213
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.