How much rates vary
Facilitymedian $5,248 · 10th to 90th $2,951 to $23,442Professionalmedian $3,388 · 10th to 90th $1,820 to $6,761
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 $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $3,467.37 | Professional | None | $2,691.53 | $2,951.21 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $5,248.07 Typical High $5,248.07 | Facility | None | $2,818.38 | $5,248.07 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $5,128.61 Median $5,754.40 Typical High $9,772.37 | Professional | None | $5,128.61 | $5,754.40 | $9,772.37 |
Medica Setting Facility Modifier None Typical Low $2,951.21 Median $5,011.87 Typical High $23,442.29 | Facility | None | $2,951.21 | $5,011.87 | $23,442.29 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,778.28 | $2,290.87 | $3,630.78 |
Medica Setting Professional Modifier RR · Rental Typical Low $707.95 Median $933.25 Typical High $1,380.38 | Professional | RR · Rental | $707.95 | $933.25 | $1,380.38 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $1,659.59 Median $2,187.76 Typical High $3,311.31 | Professional | UE · Used equipment | $1,659.59 | $2,187.76 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $9,772.37 | Professional | None | $5,128.61 | $5,128.61 | $9,772.37 |
Midlands Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $6,456.54 Median $9,772.37 Typical High $12,589.25 | Professional | None | $6,456.54 | $9,772.37 | $12,589.25 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,290.87 | $3,467.37 |
United Setting Professional Modifier RR · Rental Typical Low $676.08 Median $933.25 Typical High $1,380.38 | Professional | RR · Rental | $676.08 | $933.25 | $1,380.38 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,584.89 Median $2,187.76 Typical High $3,311.31 | Professional | UE · Used equipment | $1,584.89 | $2,187.76 | $3,311.31 |
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 $407.38 Median $446.68 Typical High $524.81 | Professional | 55 · Aftercare only | $407.38 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | KM · Facial prosthesis, new mold | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | KN · Facial prosthesis, prior mold | $575.44 | $575.44 | $575.44 |
Where Nebraska sits
The same service costs 2.2 times more in Hawaii than in Colorado. 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· 19th of 51
$3,467
HI $5,370CO $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.