How much rates vary
Facilitymedian $2,291 · 10th to 90th $708 to $7,762Professionalmedian $1,622 · 10th to 90th $1,202 to $2,239
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 $1,513.56 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,621.81 | $2,238.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $162.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,412.54 | $2,398.83 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $891.25 Typical High $1,513.56 | Professional | 54 · Surgery only | $630.96 | $891.25 | $1,513.56 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $169.82 Typical High $288.40 | Professional | 55 · Aftercare only | $117.49 | $169.82 | $288.40 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $144.54 Typical High $245.47 | Professional | 56 · Pre-op care only | $102.33 | $144.54 | $245.47 |
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 $1,318.26 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,318.26 | $2,041.74 | $2,454.71 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $7,762.47 | Facility | None | $812.83 | $2,630.27 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,479.11 | $2,089.30 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Where Rhode Island sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.