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 $9.33 Median $38.02 Typical High $38.02 | Professional | None | $9.33 | $38.02 | $38.02 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $13.18 Median $26.30 Typical High $31.62 | Facility | None | $13.18 | $26.30 | $31.62 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $9.77 Median $13.18 Typical High $13.18 | Professional | None | $9.77 | $13.18 | $13.18 |
BCBS Rhode Island Setting Professional Modifier TF · Intermediate care level Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | TF · Intermediate care level | $42.66 | $42.66 | $48.98 |
BCBS Rhode Island Setting Professional Modifier U1 · State-defined Typical Low $9.77 Median $9.77 Typical High $11.22 | Professional | U1 · State-defined | $9.77 | $9.77 | $11.22 |
BCBS Rhode Island Setting Professional Modifier U2 · State-defined Typical Low $9.77 Median $9.77 Typical High $11.22 | Professional | U2 · State-defined | $9.77 | $9.77 | $11.22 |
United Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
2 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 55 · Aftercare only Typical Low $1.41 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $1.41 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $0.93 | $3.80 | $3.80 |
Where Rhode Island sits
The same service costs 331.1 times more in New Jersey 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· 13th of 51
$13.18
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.