How much rates vary
Facilitymedian $1,905 · 10th to 90th $871 to $5,888Professionalmedian $324 · 10th to 90th $182 to $589
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 $208.93 Median $245.47 Typical High $346.74 | Professional | None | $208.93 | $245.47 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $218.78 Typical High $263.03 | Professional | 54 · Surgery only | $154.88 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $43.65 Typical High $52.48 | Professional | 55 · Aftercare only | $30.90 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $29.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $20.89 | $29.51 | $34.67 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $389.05 | Professional | None | $218.78 | $316.23 | $389.05 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $218.78 Typical High $309.03 | Professional | 54 · Surgery only | $120.23 | $218.78 | $309.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.92 Typical High $38.90 | Professional | 55 · Aftercare only | $15.14 | $26.92 | $38.90 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $26.92 Typical High $38.90 | Professional | 56 · Pre-op care only | $15.14 | $26.92 | $38.90 |
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 $281.84 Median $331.13 Typical High $616.60 | Professional | None | $281.84 | $331.13 | $616.60 |
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 $141.25 Median $302.00 Typical High $436.52 | Professional | None | $141.25 | $302.00 | $436.52 |
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 $102.33 Median $147.91 Typical High $173.78 | Professional | 52 · Reduced service | $102.33 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $58.88 Typical High $69.18 | Professional | 53 · Discontinued | $41.69 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $204.17 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $144.54 | $204.17 | $245.47 |
Where Rhode Island sits
The same service costs 6.3 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 $4,654MT $736
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.