How much rates vary
Facilitymedian $1,202 · 10th to 90th $372 to $6,457Professionalmedian $1,862 · 10th to 90th $1,349 to $2,630
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 $1,862.09 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,862.09 | $1,862.09 | $2,691.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $186.21 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,621.81 | $2,754.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,148.15 Typical High $1,949.84 | Professional | 54 · Surgery only | $812.83 | $1,148.15 | $1,949.84 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $125.89 Typical High $208.93 | Professional | 55 · Aftercare only | $87.10 | $125.89 | $208.93 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $112.20 Typical High $186.21 | Professional | 56 · Pre-op care only | $77.62 | $112.20 | $186.21 |
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 $1,778.28 Median $2,454.71 Typical High $2,818.38 | Professional | None | $1,778.28 | $2,454.71 | $2,818.38 |
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 $1,230.27 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,737.80 | $2,398.83 |
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 $933.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
Where Rhode Island sits
The same service costs 14.0 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 $28,122MD $2,008
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.