How much rates vary
Facilitymedian $832 · 10th to 90th $389 to $3,981Professionalmedian $191 · 10th to 90th $120 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 $131.83 Median $199.53 Typical High $239.88 | Professional | None | $131.83 | $199.53 | $239.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $257.04 | Professional | None | $117.49 | $177.83 | $257.04 |
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 $190.55 Median $239.88 Typical High $288.40 | Professional | None | $190.55 | $239.88 | $288.40 |
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 $154.88 Typical High $288.40 | Professional | None | $97.72 | $154.88 | $288.40 |
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 $66.07 Median $91.20 Typical High $100.00 | Professional | 52 · Reduced service | $66.07 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $36.31 Typical High $40.74 | Professional | 53 · Discontinued | $26.30 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $138.04 Typical High $151.36 | Professional | 54 · Surgery only | $100.00 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $27.54 Typical High $30.20 | Professional | 55 · Aftercare only | $19.95 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $18.20 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.18 | $18.20 | $19.95 |
Where Rhode Island sits
The same service costs 6.3 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 $2,712MT $427
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.