How much rates vary
Facilitymedian $4,677 · 10th to 90th $3,631 to $21,380Professionalmedian $3,020 · 10th to 90th $1,622 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 $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $3,162.28 | Professional | None | $2,454.71 | $2,691.53 | $3,162.28 |
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 $5,248.07 Typical High $8,912.51 | Professional | None | $4,570.88 | $5,248.07 | $8,912.51 |
Medica Setting Facility Modifier None Typical Low $2,691.53 Median $4,570.88 Typical High $21,379.62 | Facility | None | $2,691.53 | $4,570.88 | $21,379.62 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,584.89 | $2,089.30 | $3,311.31 |
Medica Setting Professional Modifier RR · Rental Typical Low $630.96 Median $831.76 Typical High $1,258.93 | Professional | RR · Rental | $630.96 | $831.76 | $1,258.93 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $1,995.26 Typical High $3,019.95 | Professional | UE · Used equipment | $1,513.56 | $1,995.26 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $8,912.51 | Professional | None | $4,570.88 | $4,570.88 | $8,912.51 |
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 $5,754.40 Median $8,912.51 Typical High $11,481.54 | Professional | None | $5,754.40 | $8,912.51 | $11,481.54 |
United 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 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,513.56 | $2,089.30 | $3,090.30 |
United Setting Professional Modifier RR · Rental Typical Low $602.56 Median $831.76 Typical High $1,258.93 | Professional | RR · Rental | $602.56 | $831.76 | $1,258.93 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,445.44 Median $1,995.26 Typical High $2,951.21 | Professional | UE · Used equipment | $1,445.44 | $1,995.26 | $2,951.21 |
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 $363.08 Median $398.11 Typical High $467.74 | Professional | 55 · Aftercare only | $363.08 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $269.15 |
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 Nebraska 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.
Nebraska· 32nd of 51
$3,090
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.