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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,148.15 Median $5,248.07 Typical High $7,943.28 | Facility | None | $1,148.15 | $5,248.07 | $7,943.28 |
BCBS Arizona Setting Professional Modifier None Typical Low $3,311.31 Median $3,801.89 Typical High $6,918.31 | Professional | None | $3,311.31 | $3,801.89 | $6,918.31 |
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 |
Medica Setting Facility Modifier None Typical Low $2,089.30 Median $4,677.35 Typical High $21,379.62 | Facility | None | $2,089.30 | $4,677.35 | $21,379.62 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $23,988.33 | Professional | None | $1,862.09 | $2,884.03 | $23,988.33 |
Medica Setting Professional Modifier RR · Rental Typical Low $741.31 Median $812.83 Typical High $1,230.27 | Professional | RR · Rental | $741.31 | $812.83 | $1,230.27 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $1,905.46 Typical High $2,884.03 | Professional | UE · Used equipment | $1,778.28 | $1,905.46 | $2,884.03 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,819.70 | $2,041.74 | $3,019.95 |
United Setting Professional Modifier RR · Rental Typical Low $741.31 Median $812.83 Typical High $1,230.27 | Professional | RR · Rental | $741.31 | $812.83 | $1,230.27 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $1,905.46 Typical High $2,884.03 | Professional | UE · Used equipment | $1,778.28 | $1,905.46 | $2,884.03 |
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 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $524.81 |
Where Arizona 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.
Arizona· 38th of 51
$3,020
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.