How much rates vary
Facilitymedian $2,399 · 10th to 90th $871 to $5,888Professionalmedian $661 · 10th to 90th $501 to $891
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 $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $977.24 | Professional | None | $436.52 | $588.84 | $977.24 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $416.87 Typical High $691.83 | Professional | 54 · Surgery only | $288.40 | $416.87 | $691.83 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $44.67 Typical High $75.86 | Professional | 55 · Aftercare only | $31.62 | $44.67 | $75.86 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $39.81 Typical High $66.07 | Professional | 56 · Pre-op care only | $28.18 | $39.81 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,238.72 Typical High $3,235.94 | Facility | None | $676.08 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,023.29 | Professional | None | $645.65 | $891.25 | $1,023.29 |
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 $436.52 Median $645.65 Typical High $851.14 | Professional | None | $436.52 | $645.65 | $851.14 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $467.74 |
Where Rhode Island sits
The same service costs 4.7 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 $6,874MT $1,466
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.