How much rates vary
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 Professional Modifier None Typical Low $19.05 Median $24.55 Typical High $38.02 | Professional | None | $19.05 | $24.55 | $38.02 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $48.98 Median $234.42 Typical High $275.42 | Facility | None | $48.98 | $234.42 | $275.42 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $16.60 Median $27.54 Typical High $53.70 | Professional | None | $16.60 | $27.54 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $1,202.26 | Facility | None | $269.15 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $34.67 Typical High $63.10 | Professional | None | $23.44 | $34.67 | $63.10 |
United Setting Facility Modifier None Typical Low $97.72 Median $295.12 Typical High $3,890.45 | Facility | None | $97.72 | $295.12 | $3,890.45 |
United Setting Professional Modifier None Typical Low $18.62 Median $28.18 Typical High $53.70 | Professional | None | $18.62 | $28.18 | $53.70 |
5 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 $9.55 Median $11.22 Typical High $19.05 | Professional | 52 · Reduced service | $9.55 | $11.22 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $4.47 Typical High $7.76 | Professional | 53 · Discontinued | $3.80 | $4.47 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $16.60 Typical High $28.84 | Professional | 54 · Surgery only | $14.45 | $16.60 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.31 Typical High $5.75 | Professional | 55 · Aftercare only | $2.88 | $3.31 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.24 Typical High $3.80 | Professional | 56 · Pre-op care only | $1.91 | $2.24 | $3.80 |
Where Rhode Island sits
The same service costs 3.5 times more in Wisconsin 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.
Rhode Island· 15th of 51
$37.15
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.