How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,230 to $10,233Professionalmedian $1,259 · 10th to 90th $933 to $1,778
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 $3,715.35 Median $3,981.07 Typical High $4,897.79 | Facility | None | $3,715.35 | $3,981.07 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,258.93 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,862.09 | Professional | None | $831.76 | $1,122.02 | $1,862.09 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $691.83 Typical High $1,174.90 | Professional | 54 · Surgery only | $489.78 | $691.83 | $1,174.90 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $131.83 Typical High $223.87 | Professional | 55 · Aftercare only | $93.33 | $131.83 | $223.87 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $112.20 Typical High $190.55 | Professional | 56 · Pre-op care only | $79.43 | $112.20 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $3,981.07 Typical High $5,623.41 | Facility | None | $1,778.28 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,584.89 | $1,905.46 |
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 $831.76 Median $1,148.15 Typical High $1,621.81 | Professional | None | $831.76 | $1,148.15 | $1,621.81 |
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 $630.96 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $870.96 |
Where Rhode Island sits
The same service costs 4.2 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 $11,551MT $2,762
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.