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 $40.74 Median $46.77 Typical High $67.61 | Professional | None | $40.74 | $46.77 | $67.61 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $26.30 Median $52.48 Typical High $79.43 | Professional | None | $26.30 | $52.48 | $79.43 |
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 $45.71 Median $61.66 Typical High $107.15 | Professional | None | $45.71 | $61.66 | $107.15 |
United Setting Facility Modifier None Typical Low $97.72 Median $204.17 Typical High $3,890.45 | Facility | None | $97.72 | $204.17 | $3,890.45 |
United Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $83.18 | Professional | None | $33.11 | $47.86 | $83.18 |
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 $20.42 Median $20.89 Typical High $33.11 | Professional | 52 · Reduced service | $20.42 | $20.89 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.32 Typical High $13.49 | Professional | 53 · Discontinued | $8.13 | $8.32 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.31 Typical High $10.00 | Professional | 55 · Aftercare only | $6.17 | $6.31 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.17 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.07 | $4.17 | $6.76 |
Where Rhode Island sits
The same service costs 3.5 times more in Wisconsin than in Utah. 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· 18th of 51
$60.26
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.