How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,023 to $10,471Professionalmedian $692 · 10th to 90th $479 to $1,000
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 $691.83 Median $691.83 Typical High $812.83 | Professional | None | $691.83 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $933.25 | Professional | None | $512.86 | $676.08 | $933.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $467.74 | Professional | 54 · Surgery only | $331.13 | $398.11 | $467.74 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $100.00 | $123.03 | $144.54 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $67.61 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $6,165.95 Typical High $8,912.51 | Facility | None | $831.76 | $6,165.95 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,122.02 | Professional | None | $758.58 | $1,000.00 | $1,122.02 |
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 $446.68 Median $549.54 Typical High $1,023.29 | Professional | None | $446.68 | $549.54 | $1,023.29 |
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 $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $489.78 |
Where Rhode Island sits
The same service costs 7.5 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 $13,659MT $1,825
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.