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 Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | None | $891.25 | $977.24 | $1,148.15 |
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 $1,905.46 Typical High $3,235.94 | Professional | None | $1,698.24 | $1,905.46 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $1,659.59 Typical High $7,762.47 | Facility | None | $977.24 | $1,659.59 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,202.26 | Professional | None | $588.84 | $758.58 | $1,202.26 |
Medica Setting Professional Modifier RR · Rental Typical Low $234.42 Median $309.03 Typical High $457.09 | Professional | RR · Rental | $234.42 | $309.03 | $457.09 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $549.54 Median $724.44 Typical High $1,096.48 | Professional | UE · Used equipment | $549.54 | $724.44 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,698.24 | $1,698.24 | $3,235.94 |
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 $2,137.96 Median $3,235.94 Typical High $4,168.69 | Professional | None | $2,137.96 | $3,235.94 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
United Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,148.15 | Professional | None | $549.54 | $758.58 | $1,148.15 |
United Setting Professional Modifier RR · Rental Typical Low $223.87 Median $309.03 Typical High $457.09 | Professional | RR · Rental | $223.87 | $309.03 | $457.09 |
United Setting Professional Modifier UE · Used equipment Typical Low $524.81 Median $724.44 Typical High $1,071.52 | Professional | UE · Used equipment | $524.81 | $724.44 | $1,071.52 |
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 $134.90 Median $147.91 Typical High $173.78 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $97.72 |
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 Nebraska 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.
Nebraska· 18th of 51
$1,148
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.