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 Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,137.96 | Facility | None | $2,041.74 | $2,041.74 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,398.83 | Professional | None | $2,041.74 | $2,041.74 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $363.08 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,380.38 Median $1,905.46 Typical High $2,041.74 | Professional | KM · Facial prosthesis, new mold | $1,380.38 | $1,905.46 | $2,041.74 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $575.44 Median $812.83 Typical High $851.14 | Professional | KN · Facial prosthesis, prior mold | $575.44 | $812.83 | $851.14 |
Aetna Setting Professional Modifier RR · Rental Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | RR · Rental | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $5,623.41 | Facility | None | $2,818.38 | $2,818.38 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,398.83 | $2,398.83 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $3,630.78 Median $7,413.10 Typical High $7,413.10 | Professional | None | $3,630.78 | $7,413.10 | $7,413.10 |
Horizon BCBS Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Facility | None | $5,128.61 | $5,128.61 | $6,165.95 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $5,370.32 | Professional | None | $2,511.89 | $2,951.21 | $5,370.32 |
United Setting Professional Modifier RR · Rental Typical Low $1,000.00 Median $1,202.26 Typical High $2,187.76 | Professional | RR · Rental | $1,000.00 | $1,202.26 | $2,187.76 |
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 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $239.88 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $239.88 |
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | MS · Maintenance fee | $1,445.44 | $1,445.44 | $1,445.44 |
United Setting Professional Modifier UE · Used equipment Typical Low $2,344.23 Median $2,818.38 Typical High $5,248.07 | Professional | UE · Used equipment | $2,344.23 | $2,818.38 | $5,248.07 |
Where New Jersey 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.
New Jersey· 31st of 51
$2,754
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.