How much rates vary
Facilitymedian $251 · 10th to 90th $112 to $3,890Professionalmedian $398 · 10th to 90th $263 to $575
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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $398.11 | Professional | None | $346.74 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $257.04 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $51.29 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $39.81 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $549.54 | Professional | None | $281.84 | $346.74 | $549.54 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $281.84 | Professional | 54 · Surgery only | $165.96 | $208.93 | $281.84 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $63.10 Typical High $85.11 | Professional | 55 · Aftercare only | $51.29 | $63.10 | $85.11 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.20 Typical High $40.74 | Professional | 56 · Pre-op care only | $23.99 | $30.20 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $1,202.26 | Facility | None | $162.18 | $218.78 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $575.44 | Professional | None | $457.09 | $501.19 | $575.44 |
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 $229.09 Median $316.23 Typical High $562.34 | Professional | None | $229.09 | $316.23 | $562.34 |
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 $173.78 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $173.78 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $69.18 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $239.88 | $275.42 | $275.42 |
Where Rhode Island sits
The same service costs 6.7 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 $2,828FL $419
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.