How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $17,783Professionalmedian $3,388 · 10th to 90th $479 to $7,586
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 $467.74 Median $870.96 Typical High $5,754.40 | Professional | None | $467.74 | $870.96 | $5,754.40 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $467.74 Median $851.14 Typical High $7,413.10 | Professional | None | $467.74 | $851.14 | $7,413.10 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $8,912.51 Typical High $12,882.50 | Facility | None | $676.08 | $8,912.51 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $977.24 Typical High $10,471.29 | Professional | None | $478.63 | $977.24 | $10,471.29 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,623.41 Typical High $19,054.61 | Facility | None | $1,230.27 | $5,623.41 | $19,054.61 |
United Setting Professional Modifier None Typical Low $562.34 Median $3,630.78 Typical High $8,912.51 | Professional | None | $562.34 | $3,630.78 | $8,912.51 |
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 $281.84 Median $363.08 Typical High $2,884.03 | Professional | 52 · Reduced service | $281.84 | $363.08 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $144.54 Typical High $1,148.15 | Professional | 53 · Discontinued | $112.20 | $144.54 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $537.03 Typical High $4,265.80 | Professional | 54 · Surgery only | $416.87 | $537.03 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $109.65 Typical High $870.96 | Professional | 55 · Aftercare only | $83.18 | $109.65 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $72.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $56.23 | $72.44 | $575.44 |
Where Rhode Island sits
The same service costs 4.3 times more in Alabama than in Maine. 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 $20,420ME $4,758
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.