How much rates vary
Facilitymedian $2,042 · 10th to 90th $871 to $5,888Professionalmedian $617 · 10th to 90th $309 to $832
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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | None | $524.81 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $398.11 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $79.43 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $52.48 | $83.18 | $83.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $933.25 | Professional | None | $302.00 | $407.38 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,621.81 Typical High $2,344.23 | Facility | None | $676.08 | $1,621.81 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $794.33 | Professional | None | $616.60 | $616.60 | $794.33 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $6,456.54 | Facility | None | $870.96 | $2,089.30 | $6,456.54 |
United Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $758.58 | Professional | None | $288.40 | $524.81 | $758.58 |
2 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 $263.03 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $263.03 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $104.71 | $165.96 | $165.96 |
Where Rhode Island sits
The same service costs 6.1 times more in Oklahoma 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
OK $6,602MT $1,074
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.