How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,479 to $35,481Professionalmedian $4,467 · 10th to 90th $617 to $11,482
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 $3,715.35 Median $3,981.07 Typical High $5,495.41 | Facility | None | $3,715.35 | $3,981.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $8,511.38 | Professional | None | $616.60 | $812.83 | $8,511.38 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $11,748.98 | Professional | None | $562.34 | $1,000.00 | $11,748.98 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $16,218.10 Typical High $22,908.68 | Facility | None | $676.08 | $16,218.10 | $22,908.68 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $13,182.57 | Professional | None | $794.33 | $1,174.90 | $13,182.57 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $6,309.57 Typical High $40,738.03 | Facility | None | $1,698.24 | $6,309.57 | $40,738.03 |
United Setting Professional Modifier None Typical Low $630.96 Median $4,677.35 Typical High $11,481.54 | Professional | None | $630.96 | $4,677.35 | $11,481.54 |
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 $309.03 Median $407.38 Typical High $4,265.80 | Professional | 52 · Reduced service | $309.03 | $407.38 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $162.18 Typical High $1,698.24 | Professional | 53 · Discontinued | $123.03 | $162.18 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $602.56 Typical High $6,309.57 | Professional | 54 · Surgery only | $467.74 | $602.56 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $120.23 Typical High $1,288.25 | Professional | 55 · Aftercare only | $93.33 | $120.23 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $81.28 Typical High $851.14 | Professional | 56 · Pre-op care only | $61.66 | $81.28 | $851.14 |
Where Rhode Island sits
The same service costs 6.1 times more in Alaska than in Vermont. 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
AK $33,081VT $5,424
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.