How much rates vary
Facilitymedian $2,754 · 10th to 90th $794 to $5,888Professionalmedian $550 · 10th to 90th $372 to $794
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 $501.19 Median $501.19 Typical High $602.56 | Professional | None | $501.19 | $501.19 | $602.56 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $741.31 | Professional | None | $363.08 | $457.09 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $3,548.13 Typical High $5,128.61 | Facility | None | $446.68 | $3,548.13 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $812.83 | Professional | None | $524.81 | $741.31 | $812.83 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $724.44 | Professional | None | $371.54 | $549.54 | $724.44 |
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 $251.19 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $251.19 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | 53 · Discontinued | $100.00 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | 54 · Surgery only | $380.19 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $60.26 |
Where Rhode Island sits
The same service costs 6.3 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 $7,350MT $1,166
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.