How much rates vary
Facilitymedian $437 · 10th to 90th $112 to $3,890Professionalmedian $617 · 10th to 90th $427 to $891
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 $575.44 Median $616.60 Typical High $616.60 | Professional | None | $575.44 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $436.52 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $87.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $57.54 | $61.66 | $61.66 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $831.76 | Professional | None | $426.58 | $562.34 | $831.76 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $331.13 Typical High $426.58 | Professional | 54 · Surgery only | $275.42 | $331.13 | $426.58 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $128.82 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $128.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $47.86 Typical High $61.66 | Professional | 56 · Pre-op care only | $39.81 | $47.86 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $223.87 Typical High $794.33 | Facility | None | $162.18 | $223.87 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $954.99 | Professional | None | $676.08 | $831.76 | $954.99 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $870.96 | Professional | None | $371.54 | $501.19 | $870.96 |
3 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 $288.40 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $288.40 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $114.82 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $407.38 | $436.52 | $436.52 |
Where Rhode Island sits
The same service costs 4.7 times more in New York than in Florida. 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 $3,038FL $649
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.