How much rates vary
Facilitymedian $4,677 · 10th to 90th $2,884 to $21,380Professionalmedian $4,169 · 10th to 90th $2,089 to $6,026
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 Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $3,235.94 Typical High $3,715.35 | Professional | None | $1,949.84 | $3,235.94 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $4,677.35 Typical High $4,677.35 | Facility | None | $3,630.78 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $4,570.88 Median $6,025.60 Typical High $6,606.93 | Professional | None | $4,570.88 | $6,025.60 | $6,606.93 |
Hally Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $5,754.40 | Professional | None | $4,073.80 | $4,570.88 | $5,754.40 |
Medica Setting Facility Modifier None Typical Low $2,884.03 Median $4,570.88 Typical High $21,379.62 | Facility | None | $2,884.03 | $4,570.88 | $21,379.62 |
Medica Setting Professional Modifier None Typical Low $2,089.30 Median $3,801.89 Typical High $11,748.98 | Professional | None | $2,089.30 | $3,801.89 | $11,748.98 |
Medica Setting Professional Modifier RR · Rental Typical Low $812.83 Median $831.76 Typical High $1,445.44 | Professional | RR · Rental | $812.83 | $831.76 | $1,445.44 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $1,905.46 Median $1,995.26 Typical High $3,388.44 | Professional | UE · Used equipment | $1,905.46 | $1,995.26 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $4,897.79 Median $6,025.60 Typical High $6,025.60 | Professional | None | $4,897.79 | $6,025.60 | $6,025.60 |
Midlands Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $4,677.35 Median $6,918.31 Typical High $6,918.31 | Professional | None | $4,677.35 | $6,918.31 | $6,918.31 |
United Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $12,589.25 | Facility | None | $6,606.93 | $6,606.93 | $12,589.25 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,089.30 Typical High $3,715.35 | Professional | None | $2,041.74 | $2,089.30 | $3,715.35 |
United Setting Professional Modifier RR · Rental Typical Low $812.83 Median $851.14 Typical High $1,479.11 | Professional | RR · Rental | $812.83 | $851.14 | $1,479.11 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,905.46 Median $1,995.26 Typical High $3,467.37 | Professional | UE · Used equipment | $1,905.46 | $1,995.26 | $3,467.37 |
Wellmark Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
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 $288.40 Median $489.78 Typical High $562.34 | Professional | 55 · Aftercare only | $288.40 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $269.15 Typical High $446.68 | Professional | 56 · Pre-op care only | $186.21 | $269.15 | $446.68 |
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 Iowa 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.
Iowa· 6th of 51
$4,169
HI $4,898DC $2,399
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.