How much rates vary
Facilitymedian $2,455 · 10th to 90th $871 to $5,888Professionalmedian $457 · 10th to 90th $282 to $2,512
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 $371.54 Median $501.19 Typical High $794.33 | Professional | None | $371.54 | $501.19 | $794.33 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $239.88 Median $616.60 Typical High $1,548.82 | Professional | None | $239.88 | $616.60 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,238.72 Typical High $3,235.94 | Facility | None | $676.08 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $2,511.89 | Professional | None | $398.11 | $537.03 | $2,511.89 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,079.46 | Facility | None | $870.96 | $2,089.30 | $7,079.46 |
United Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $2,137.96 | Professional | None | $281.84 | $407.38 | $2,137.96 |
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 $186.21 Median $186.21 Typical High $251.19 | Professional | 52 · Reduced service | $186.21 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | 53 · Discontinued | $74.13 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $380.19 | Professional | 54 · Surgery only | $281.84 | $281.84 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $75.86 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $50.12 |
Where Rhode Island sits
The same service costs 4.3 times more in Vermont 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
VT $8,043ME $1,891
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.