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 $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $11.75 Median $15.49 Typical High $23.99 | Professional | None | $11.75 | $15.49 | $23.99 |
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 $18.62 Median $19.05 Typical High $27.54 | Professional | None | $18.62 | $19.05 | $27.54 |
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 $10.96 Median $16.98 Typical High $21.38 | Professional | None | $10.96 | $16.98 | $21.38 |
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 $7.76 Median $7.76 Typical High $7.76 | Professional | 52 · Reduced service | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 53 · Discontinued | $3.09 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 55 · Aftercare only | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.55 | $1.55 | $1.55 |
Where Rhode Island sits
The same service costs 12.3 times more in Florida 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· 38th of 51
$17.38
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.