How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $25.12 Median $28.84 Typical High $89.13 | Professional | None | $25.12 | $28.84 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $14.45 Typical High $44.67 | Professional | 52 · Reduced service | $12.59 | $14.45 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.75 Typical High $17.78 | Professional | 53 · Discontinued | $5.01 | $5.75 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.27 Typical High $13.49 | Professional | 55 · Aftercare only | $3.80 | $4.27 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.88 Typical High $8.91 | Professional | 56 · Pre-op care only | $2.51 | $2.88 | $8.91 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $151.36 Median $239.88 Typical High $295.12 | Facility | None | $151.36 | $239.88 | $295.12 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $23.44 Median $43.65 Typical High $93.33 | Professional | None | $23.44 | $43.65 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $44.67 Typical High $87.10 | Professional | None | $21.38 | $44.67 | $87.10 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $16.60 Median $38.02 Typical High $70.79 | Professional | None | $16.60 | $38.02 | $70.79 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Rhode Island sits
The same service costs 4.4 times more in Hawaii than in Washington, DC. 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· 47th of 51
$38.02
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.