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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,288.25 | $3,019.95 | $3,235.94 |
CareSource Setting Professional Modifier None Typical Low $1,380.38 Median $3,311.31 Typical High $5,888.44 | Professional | None | $1,380.38 | $3,311.31 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $6,918.31 | Facility | None | $2,818.38 | $2,818.38 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $24,547.09 | Professional | None | $2,398.83 | $2,398.83 | $24,547.09 |
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 $2,454.71 Median $3,090.30 Typical High $5,623.41 | Professional | None | $2,454.71 | $3,090.30 | $5,623.41 |
United Setting Professional Modifier RR · Rental Typical Low $977.24 Median $1,258.93 Typical High $2,238.72 | Professional | RR · Rental | $977.24 | $1,258.93 | $2,238.72 |
United Setting Professional Modifier UE · Used equipment Typical Low $2,344.23 Median $2,951.21 Typical High $5,370.32 | Professional | UE · Used equipment | $2,344.23 | $2,951.21 | $5,370.32 |
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 $371.54 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $371.54 |
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 West Virginia 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.
West Virginia· 46th of 51
$2,512
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.