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 $16.98 Median $17.38 Typical High $24.55 | Professional | None | $16.98 | $17.38 | $24.55 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $8.13 Median $363.08 Typical High $549.54 | Facility | None | $8.13 | $363.08 | $549.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $12.59 Median $15.49 Typical High $27.54 | Professional | None | $12.59 | $15.49 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $7.24 Median $9.77 Typical High $794.33 | Facility | None | $7.24 | $9.77 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $26.30 Typical High $33.11 | Professional | None | $16.98 | $26.30 | $33.11 |
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 $13.80 Median $19.50 Typical High $33.11 | Professional | None | $13.80 | $19.50 | $33.11 |
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 $8.71 Median $8.71 Typical High $12.30 | Professional | 52 · Reduced service | $8.71 | $8.71 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $4.90 | Professional | 53 · Discontinued | $3.47 | $3.47 | $4.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.88 Median $12.88 Typical High $18.62 | Professional | 54 · Surgery only | $12.88 | $12.88 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $3.72 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $2.45 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in New York. 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· 19th of 51
$21.38
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.