How much rates vary
Facilitymedian $603 · 10th to 90th $98 to $3,981Professionalmedian $479 · 10th to 90th $155 to $1,230
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 $154.88 Median $234.42 Typical High $912.01 | Professional | None | $154.88 | $234.42 | $912.01 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $1,258.93 | Professional | None | $162.18 | $288.40 | $1,258.93 |
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 $223.87 Median $331.13 Typical High $1,412.54 | Professional | None | $223.87 | $331.13 | $1,412.54 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $158.49 Median $501.19 Typical High $1,230.27 | Professional | None | $158.49 | $501.19 | $1,230.27 |
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 $77.62 Median $100.00 Typical High $457.09 | Professional | 52 · Reduced service | $77.62 | $100.00 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $181.97 | Professional | 53 · Discontinued | $30.90 | $40.74 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $151.36 Typical High $676.08 | Professional | 54 · Surgery only | $117.49 | $151.36 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.20 Typical High $138.04 | Professional | 55 · Aftercare only | $23.44 | $30.20 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $91.20 | Professional | 56 · Pre-op care only | $15.49 | $20.42 | $91.20 |
Where Rhode Island sits
The same service costs 17.4 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 $9,157MT $526
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.