How much rates vary
Facilitymedian $2,630 · 10th to 90th $851 to $6,026Professionalmedian $741 · 10th to 90th $525 to $1,047
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 $3,467.37 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,467.37 | $3,715.35 | $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 $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
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 $562.34 Median $741.31 Typical High $1,071.52 | Professional | None | $562.34 | $741.31 | $1,071.52 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $489.78 Typical High $575.44 | Professional | 54 · Surgery only | $398.11 | $489.78 | $575.44 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $67.61 | $83.18 | $97.72 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $57.54 | $70.79 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,951.21 | Facility | None | $1,148.15 | $1,548.82 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,174.90 | Professional | None | $851.14 | $977.24 | $1,174.90 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $7,762.47 | Facility | None | $812.83 | $2,630.27 | $7,762.47 |
United Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,096.48 | Professional | None | $478.63 | $616.60 | $1,096.48 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $457.09 |
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 $8,738MT $1,845
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.