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 $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $147.91 | Professional | None | $70.79 | $95.50 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $794.33 | Facility | None | $676.08 | $676.08 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $151.36 | Professional | None | $102.33 | $114.82 | $151.36 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $128.82 | Professional | None | $66.07 | $97.72 | $128.82 |
4 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 $45.71 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Where Rhode Island sits
The same service costs 4.5 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· 37th of 51
$97.72
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.