How much rates vary
Facilitymedian $1,905 · 10th to 90th $871 to $5,888Professionalmedian $437 · 10th to 90th $347 to $661
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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $426.58 | Professional | None | $371.54 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $275.42 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $37.15 | $42.66 | $42.66 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $645.65 | Professional | None | $371.54 | $436.52 | $645.65 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $309.03 Typical High $398.11 | Professional | 54 · Surgery only | $213.80 | $309.03 | $398.11 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $87.10 Typical High $114.82 | Professional | 55 · Aftercare only | $61.66 | $87.10 | $114.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $43.65 Typical High $57.54 | Professional | 56 · Pre-op care only | $30.90 | $43.65 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,412.54 Typical High $2,041.74 | Facility | None | $588.84 | $1,412.54 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $660.69 Typical High $660.69 | Professional | None | $380.19 | $660.69 | $660.69 |
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 $269.15 Median $363.08 Typical High $575.44 | Professional | None | $269.15 | $363.08 | $575.44 |
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 $186.21 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $186.21 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $257.04 | $295.12 | $295.12 |
Where Rhode Island sits
The same service costs 4.5 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 $4,914MT $1,099
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.