How much rates vary
Facilitymedian $3,715 · 10th to 90th $933 to $10,233Professionalmedian $794 · 10th to 90th $617 to $1,023
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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $794.33 | Professional | None | $691.83 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | None | $724.44 | $851.14 | $851.14 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $407.38 | $575.44 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $72.44 Typical High $85.11 | Professional | 55 · Aftercare only | $51.29 | $72.44 | $85.11 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $72.44 Typical High $85.11 | Professional | 56 · Pre-op care only | $51.29 | $72.44 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,981.07 Typical High $5,623.41 | Facility | None | $831.76 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $954.99 | Professional | None | $588.84 | $645.65 | $954.99 |
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 $398.11 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Where Rhode Island sits
The same service costs 5.4 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 $11,084MT $2,070
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.