How much rates vary
Facilitymedian $3,890 · 10th to 90th $708 to $10,471Professionalmedian $2,291 · 10th to 90th $1,778 to $3,020
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 $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $229.09 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,089.30 | $2,454.71 | $2,454.71 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,698.24 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,174.90 | $1,698.24 | $1,995.26 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $144.54 | $208.93 | $245.47 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $186.21 Typical High $218.78 | Professional | 56 · Pre-op care only | $131.83 | $186.21 | $218.78 |
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 $2,884.03 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,884.03 | $3,019.95 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,023.29 | $4,570.88 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,698.24 | $1,862.09 | $2,818.38 |
1 more rate 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 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,621.81 |
Where Rhode Island sits
The same service costs 7.2 times more in Maine than in Delaware. 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 $28,702DE $3,966
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.