How much rates vary
Facilitymedian $2,089 · 10th to 90th $871 to $5,888Professionalmedian $562 · 10th to 90th $398 to $832
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 $457.09 Median $537.03 Typical High $616.60 | Professional | None | $457.09 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | 54 · Surgery only | $338.84 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $91.20 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $61.66 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $61.66 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $812.83 | Professional | None | $407.38 | $562.34 | $812.83 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $380.19 Typical High $602.56 | Professional | 54 · Surgery only | $269.15 | $380.19 | $602.56 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $47.86 Typical High $74.13 | Professional | 55 · Aftercare only | $33.11 | $47.86 | $74.13 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $42.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $30.20 | $42.66 | $66.07 |
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 $562.34 Median $741.31 Typical High $1,047.13 | Professional | None | $562.34 | $741.31 | $1,047.13 |
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 $316.23 Median $489.78 Typical High $870.96 | Professional | None | $316.23 | $489.78 | $870.96 |
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 $229.09 Median $229.09 Typical High $309.03 | Professional | 52 · Reduced service | $229.09 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $123.03 | Professional | 53 · Discontinued | $91.20 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $426.58 |
Where Rhode Island sits
The same service costs 3.9 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 $4,927MT $1,254
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.