How much rates vary
Facilitymedian $832 · 10th to 90th $389 to $3,981Professionalmedian $151 · 10th to 90th $112 to $204
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 $128.82 Median $151.36 Typical High $151.36 | Professional | None | $128.82 | $151.36 | $151.36 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $239.88 | Professional | None | $104.71 | $138.04 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $794.33 | Facility | None | $446.68 | $616.60 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $229.09 | Professional | None | $154.88 | $181.97 | $229.09 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $190.55 | Professional | None | $97.72 | $147.91 | $190.55 |
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 $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 54 · Surgery only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Where Rhode Island sits
The same service costs 8.1 times more in New York 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
NY $2,852MT $352
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.