How much rates vary
Facilitymedian $2,089 · 10th to 90th $776 to $5,888Professionalmedian $1,950 · 10th to 90th $1,259 to $2,818
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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,737.80 | $1,737.80 | $2,570.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,445.44 | $1,949.84 | $2,951.21 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,202.26 Typical High $1,862.09 | Professional | 54 · Surgery only | $851.14 | $1,202.26 | $1,862.09 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $263.03 Typical High $407.38 | Professional | 55 · Aftercare only | $186.21 | $263.03 | $407.38 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $181.97 Typical High $275.42 | Professional | 56 · Pre-op care only | $125.89 | $181.97 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $676.08 Typical High $1,202.26 | Facility | None | $50.12 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $3,090.30 | Professional | None | $1,445.44 | $2,344.23 | $3,090.30 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,862.09 | $2,570.40 |
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 $870.96 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Where Rhode Island sits
The same service costs 10.1 times more in Maine than in Maryland. 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
ME $27,746MD $2,744
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.