How much rates vary
Facilitymedian $2,884 · 10th to 90th $871 to $6,918Professionalmedian $708 · 10th to 90th $427 to $1,072
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 $537.03 Median $602.56 Typical High $776.25 | Professional | None | $537.03 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $457.09 Typical High $588.84 | Professional | 54 · Surgery only | $398.11 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $91.20 Typical High $117.49 | Professional | 55 · Aftercare only | $79.43 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $60.26 Typical High $77.62 | Professional | 56 · Pre-op care only | $53.70 | $60.26 | $77.62 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $416.87 Median $616.60 Typical High $851.14 | Professional | None | $416.87 | $616.60 | $851.14 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $346.74 Typical High $501.19 | Professional | 54 · Surgery only | $239.88 | $346.74 | $501.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $107.15 Typical High $151.36 | Professional | 55 · Aftercare only | $72.44 | $107.15 | $151.36 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $51.29 Typical High $72.44 | Professional | 56 · Pre-op care only | $34.67 | $51.29 | $72.44 |
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 $707.95 Median $812.83 Typical High $1,071.52 | Professional | None | $707.95 | $812.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $1,000.00 | Professional | None | $346.74 | $549.54 | $1,000.00 |
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 $269.15 Median $302.00 Typical High $389.05 | Professional | 52 · Reduced service | $269.15 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $120.23 Typical High $158.49 | Professional | 53 · Discontinued | $107.15 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $426.58 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $371.54 | $426.58 | $549.54 |
Where Rhode Island sits
The same service costs 6.5 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 $9,949MT $1,532
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.