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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $1,905.46 Typical High $1,995.26 | Facility | None | $794.33 | $1,905.46 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $870.96 Median $2,041.74 Typical High $3,715.35 | Professional | None | $870.96 | $2,041.74 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $4,466.84 | Facility | None | $2,238.72 | $2,238.72 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $16,218.10 | Professional | None | $1,905.46 | $1,905.46 | $16,218.10 |
United Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $3,890.45 | Professional | None | $1,737.80 | $2,137.96 | $3,890.45 |
United Setting Professional Modifier RR · Rental Typical Low $691.83 Median $870.96 Typical High $1,584.89 | Professional | RR · Rental | $691.83 | $870.96 | $1,584.89 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,621.81 Median $2,041.74 Typical High $3,715.35 | Professional | UE · Used equipment | $1,621.81 | $2,041.74 | $3,715.35 |
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 $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
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 West Virginia 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.
West Virginia· 34th 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.