How much rates vary
Facilitymedian $2,239 · 10th to 90th $776 to $7,762Professionalmedian $245 · 10th to 90th $158 to $324
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 $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $316.23 | Professional | None | $158.49 | $213.80 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,202.26 | Facility | None | $676.08 | $1,122.02 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $363.08 | Professional | None | $281.84 | $323.59 | $363.08 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $7,762.47 | Facility | None | $812.83 | $2,630.27 | $7,762.47 |
United Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $346.74 | Professional | None | $151.36 | $213.80 | $346.74 |
5 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 $123.03 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Where Rhode Island sits
The same service costs 26.3 times more in Alabama 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
AL $15,010MT $570
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.