How much rates vary
Facilitymedian $1,549 · 10th to 90th $794 to $5,888Professionalmedian $398 · 10th to 90th $240 to $776
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 $1,513.56 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,513.56 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $549.54 | Professional | None | $281.84 | $426.58 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $275.42 Typical High $407.38 | Professional | 54 · Surgery only | $208.93 | $275.42 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $54.95 Typical High $81.28 | Professional | 55 · Aftercare only | $42.66 | $54.95 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $36.31 Typical High $54.95 | Professional | 56 · Pre-op care only | $28.18 | $36.31 | $54.95 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $204.17 Median $407.38 Typical High $616.60 | Professional | None | $204.17 | $407.38 | $616.60 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $302.00 Typical High $426.58 | Professional | 54 · Surgery only | $134.90 | $302.00 | $426.58 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $38.02 Typical High $53.70 | Professional | 55 · Aftercare only | $16.60 | $38.02 | $53.70 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $38.02 Typical High $53.70 | Professional | 56 · Pre-op care only | $16.60 | $38.02 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,230.27 Typical High $1,778.28 | Facility | None | $676.08 | $1,230.27 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $776.25 | Professional | None | $323.59 | $478.63 | $776.25 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $194.98 Median $363.08 Typical High $741.31 | Professional | None | $194.98 | $363.08 | $741.31 |
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 $141.25 Median $181.97 Typical High $269.15 | Professional | 52 · Reduced service | $141.25 | $181.97 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $72.44 Typical High $109.65 | Professional | 53 · Discontinued | $56.23 | $72.44 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $257.04 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $194.98 | $257.04 | $380.19 |
Where Rhode Island sits
The same service costs 4.6 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 $4,728MT $1,029
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.