How much rates vary
Facilitymedian $1,202 · 10th to 90th $372 to $6,457Professionalmedian $1,288 · 10th to 90th $1,096 to $2,042
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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,479.11 | $2,344.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,071.52 Typical High $1,659.59 | Professional | 54 · Surgery only | $741.31 | $1,071.52 | $1,659.59 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $89.13 Typical High $138.04 | Professional | 55 · Aftercare only | $61.66 | $89.13 | $138.04 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $114.82 Typical High $177.83 | Professional | 56 · Pre-op care only | $79.43 | $114.82 | $177.83 |
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 $1,258.93 Median $1,258.93 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,258.93 | $2,398.83 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,513.56 Typical High $6,456.54 | Facility | None | $426.58 | $1,513.56 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,412.54 | $2,041.74 |
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 $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Where Rhode Island sits
The same service costs 15.0 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 $27,816MD $1,851
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.