How much rates vary
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 Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
BCBS Arizona Setting Facility Modifier None Typical Low $870.96 Median $3,890.45 Typical High $5,888.44 | Facility | None | $870.96 | $3,890.45 | $5,888.44 |
BCBS Arizona Setting Professional Modifier None Typical Low $2,511.89 Median $2,884.03 Typical High $5,248.07 | Professional | None | $2,511.89 | $2,884.03 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,905.46 | $1,905.46 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $3,235.94 Typical High $15,488.17 | Facility | None | $1,479.11 | $3,235.94 | $15,488.17 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $17,378.01 | Professional | None | $1,348.96 | $2,089.30 | $17,378.01 |
Medica Setting Professional Modifier RR · Rental Typical Low $549.54 Median $588.84 Typical High $891.25 | Professional | RR · Rental | $549.54 | $588.84 | $891.25 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $1,412.54 Typical High $2,089.30 | Professional | UE · Used equipment | $1,288.25 | $1,412.54 | $2,089.30 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,479.11 | $2,238.72 |
United Setting Professional Modifier RR · Rental Typical Low $549.54 Median $588.84 Typical High $891.25 | Professional | RR · Rental | $549.54 | $588.84 | $891.25 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $1,412.54 Typical High $2,089.30 | Professional | UE · Used equipment | $1,288.25 | $1,412.54 | $2,089.30 |
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 $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | KM · Facial prosthesis, new mold | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | KN · Facial prosthesis, prior mold | $380.19 | $380.19 | $380.19 |
Where Arizona sits
The same service costs 2.1 times more in Wisconsin than in Kentucky. 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.
Arizona· 42nd of 51
$1,905
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.