How much rates vary
Facilitymedian $3,890 · 10th to 90th $708 to $10,471Professionalmedian $1,622 · 10th to 90th $1,122 to $1,820
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 $1,318.26 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,445.44 | $1,445.44 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,000.00 Typical High $1,174.90 | Professional | 54 · Surgery only | $691.83 | $1,000.00 | $1,174.90 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $87.10 | $123.03 | $144.54 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $109.65 Typical High $131.83 | Professional | 56 · Pre-op care only | $77.62 | $109.65 | $131.83 |
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 $1,698.24 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,698.24 | $1,819.70 | $1,819.70 |
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 $1,023.29 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,318.26 | $1,737.80 |
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,148.15 |
Where Rhode Island sits
The same service costs 8.7 times more in Maine than in Kentucky. 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 $27,149KY $3,127
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.