How much rates vary
Facilitymedian $2,089 · 10th to 90th $871 to $5,888Professionalmedian $562 · 10th to 90th $417 to $794
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 $446.68 Median $478.63 Typical High $776.25 | Professional | None | $446.68 | $478.63 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $47.86 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $870.96 | Professional | None | $416.87 | $562.34 | $870.96 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $363.08 Typical High $562.34 | Professional | 54 · Surgery only | $251.19 | $363.08 | $562.34 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $66.07 Typical High $104.71 | Professional | 55 · Aftercare only | $46.77 | $66.07 | $104.71 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $47.86 Typical High $74.13 | Professional | 56 · Pre-op care only | $33.11 | $47.86 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,949.84 Typical High $2,754.23 | Facility | None | $588.84 | $1,949.84 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $933.25 | Professional | None | $588.84 | $794.33 | $933.25 |
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 $371.54 Median $478.63 Typical High $794.33 | Professional | None | $371.54 | $478.63 | $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 $234.42 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $331.13 |
Where Rhode Island sits
The same service costs 3.6 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 $5,175MT $1,450
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.