How much rates vary
Facilitymedian $2,239 · 10th to 90th $676 to $6,918Professionalmedian $417 · 10th to 90th $229 to $1,023
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 $234.42 Median $295.12 Typical High $741.31 | Professional | None | $234.42 | $295.12 | $741.31 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $199.53 Median $380.19 Typical High $1,000.00 | Professional | None | $199.53 | $380.19 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $851.14 | Facility | None | $446.68 | $676.08 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $1,348.96 | Professional | None | $288.40 | $416.87 | $1,348.96 |
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 $229.09 Median $501.19 Typical High $1,122.02 | Professional | None | $229.09 | $501.19 | $1,122.02 |
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 $117.49 Median $147.91 Typical High $371.54 | Professional | 52 · Reduced service | $117.49 | $147.91 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $58.88 Typical High $147.91 | Professional | 53 · Discontinued | $46.77 | $58.88 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $223.87 Typical High $562.34 | Professional | 54 · Surgery only | $177.83 | $223.87 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $44.67 Typical High $112.20 | Professional | 55 · Aftercare only | $35.48 | $44.67 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $29.51 Typical High $74.13 | Professional | 56 · Pre-op care only | $23.44 | $29.51 | $74.13 |
Where Rhode Island sits
The same service costs 6.9 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 $7,377MT $1,063
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.