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 $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $2,884.03 | Facility | None | $1,148.15 | $2,754.23 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $2,951.21 Typical High $5,370.32 | Professional | None | $1,258.93 | $2,951.21 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $6,165.95 | Facility | None | $3,630.78 | $3,630.78 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $22,387.21 | Professional | None | $3,090.30 | $3,090.30 | $22,387.21 |
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 $2,238.72 Median $2,818.38 Typical High $5,128.61 | Professional | None | $2,238.72 | $2,818.38 | $5,128.61 |
United Setting Professional Modifier RR · Rental Typical Low $891.25 Median $1,122.02 Typical High $2,041.74 | Professional | RR · Rental | $891.25 | $1,122.02 | $2,041.74 |
United Setting Professional Modifier UE · Used equipment Typical Low $2,137.96 Median $2,691.53 Typical High $4,786.30 | Professional | UE · Used equipment | $2,137.96 | $2,691.53 | $4,786.30 |
3 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 $338.84 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $338.84 |
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 West Virginia 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.
West Virginia· 36th 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.