How much rates vary
Facilitymedian $2,754 · 10th to 90th $832 to $7,762Professionalmedian $955 · 10th to 90th $692 to $1,479
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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $870.96 | Professional | None | $758.58 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $87.10 | $87.10 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,318.26 | Professional | None | $812.83 | $954.99 | $1,318.26 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $676.08 Typical High $812.83 | Professional | 54 · Surgery only | $467.74 | $676.08 | $812.83 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $190.55 Typical High $234.42 | Professional | 55 · Aftercare only | $134.90 | $190.55 | $234.42 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $95.50 Typical High $117.49 | Professional | 56 · Pre-op care only | $67.61 | $95.50 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $3,235.94 | Facility | None | $831.76 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,479.11 Typical High $1,479.11 | Professional | None | $776.25 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $8,709.64 | Facility | None | $812.83 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,174.90 | Professional | None | $676.08 | $741.31 | $1,174.90 |
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 $380.19 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $602.56 |
Where Rhode Island sits
The same service costs 3.6 times more in Vermont 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
VT $8,561MT $2,405
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.