How much rates vary
Facilitymedian $1,738 · 10th to 90th $1,047 to $7,762Professionalmedian $1,514 · 10th to 90th $759 to $2,239
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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,380.38 | Professional | None | $707.95 | $1,202.26 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,737.80 Typical High $1,737.80 | Facility | None | $933.25 | $1,737.80 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $2,398.83 | Professional | None | $1,698.24 | $2,238.72 | $2,398.83 |
Hally Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,548.82 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $7,762.47 | Facility | None | $1,047.13 | $1,698.24 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,380.38 Typical High $4,265.80 | Professional | None | $758.58 | $1,380.38 | $4,265.80 |
Medica Setting Professional Modifier RR · Rental Typical Low $295.12 Median $309.03 Typical High $524.81 | Professional | RR · Rental | $295.12 | $309.03 | $524.81 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $707.95 Median $724.44 Typical High $1,258.93 | Professional | UE · Used equipment | $707.95 | $724.44 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,778.28 | $2,238.72 | $2,238.72 |
Midlands Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,698.24 | $2,570.40 | $2,570.40 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $4,677.35 | Facility | None | $2,398.83 | $2,398.83 | $4,677.35 |
United Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,348.96 | Professional | None | $741.31 | $776.25 | $1,348.96 |
United Setting Professional Modifier RR · Rental Typical Low $295.12 Median $309.03 Typical High $537.03 | Professional | RR · Rental | $295.12 | $309.03 | $537.03 |
United Setting Professional Modifier UE · Used equipment Typical Low $707.95 Median $741.31 Typical High $1,288.25 | Professional | UE · Used equipment | $707.95 | $741.31 | $1,288.25 |
Wellmark Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $104.71 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $104.71 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $97.72 Typical High $151.36 | Professional | 56 · Pre-op care only | $70.79 | $97.72 | $151.36 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | KM · Facial prosthesis, new mold | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | KN · Facial prosthesis, prior mold | $190.55 | $190.55 | $190.55 |
Where Iowa 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.
Iowa· 6th of 51
$1,514
HI $1,778CO $794
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.