How much rates vary
Facilitymedian $1,622 · 10th to 90th $676 to $5,012Professionalmedian $158 · 10th to 90th $95 to $288
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 $95.50 Median $151.36 Typical High $208.93 | Professional | None | $95.50 | $151.36 | $208.93 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $83.18 Median $158.49 Typical High $295.12 | Professional | None | $83.18 | $158.49 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,621.81 Typical High $2,344.23 | Facility | None | $676.08 | $1,621.81 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $371.54 | Professional | None | $123.03 | $173.78 | $371.54 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,754.40 | Facility | None | $645.65 | $1,445.44 | $5,754.40 |
United Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $281.84 | Professional | None | $97.72 | $138.04 | $281.84 |
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 $47.86 Median $54.95 Typical High $104.71 | Professional | 52 · Reduced service | $47.86 | $54.95 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $21.88 Typical High $41.69 | Professional | 53 · Discontinued | $19.05 | $21.88 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $81.28 Typical High $154.88 | Professional | 54 · Surgery only | $72.44 | $81.28 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.22 Typical High $31.62 | Professional | 55 · Aftercare only | $14.45 | $16.22 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.96 Typical High $20.89 | Professional | 56 · Pre-op care only | $9.55 | $10.96 | $20.89 |
Where Rhode Island sits
The same service costs 9.7 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 $4,351MT $447
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.