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 $2,570.40 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier RR · Rental Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | RR · Rental | $1,318.26 | $1,318.26 | $1,318.26 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $6,918.31 Median $9,549.93 Typical High $11,220.18 | Facility | None | $6,918.31 | $9,549.93 | $11,220.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,778.28 Median $2,511.89 Typical High $4,073.80 | Professional | None | $1,778.28 | $2,511.89 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,630.78 | Professional | None | $3,090.30 | $3,090.30 | $3,630.78 |
United Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $3,981.07 | Professional | None | $1,819.70 | $2,691.53 | $3,981.07 |
United Setting Professional Modifier RR · Rental Typical Low $724.44 Median $1,071.52 Typical High $1,584.89 | Professional | RR · Rental | $724.44 | $1,071.52 | $1,584.89 |
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 55 · Aftercare only Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $257.04 | $281.84 | $281.84 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $2,691.53 Typical High $2,691.53 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $1,122.02 Typical High $1,122.02 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $1,122.02 | $1,122.02 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,737.80 Median $2,570.40 Typical High $3,801.89 | Professional | UE · Used equipment | $1,737.80 | $2,570.40 | $3,801.89 |
Where Rhode Island sits
The same service costs 2.0 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· 41st of 51
$2,818
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.