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 Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $707.95 | Facility | None | $660.69 | $660.69 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $794.33 | Professional | None | $660.69 | $660.69 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $457.09 Median $630.96 Typical High $676.08 | Professional | KM · Facial prosthesis, new mold | $457.09 | $630.96 | $676.08 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $190.55 Median $269.15 Typical High $281.84 | Professional | KN · Facial prosthesis, prior mold | $190.55 | $269.15 | $281.84 |
Aetna Setting Professional Modifier RR · Rental Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | RR · Rental | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,862.09 | Facility | None | $933.25 | $933.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | None | $794.33 | $794.33 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,202.26 | $2,454.71 | $2,454.71 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,995.26 | Facility | None | $1,698.24 | $1,698.24 | $1,995.26 |
United Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,778.28 | Professional | None | $831.76 | $977.24 | $1,778.28 |
United Setting Professional Modifier RR · Rental Typical Low $331.13 Median $398.11 Typical High $724.44 | Professional | RR · Rental | $331.13 | $398.11 | $724.44 |
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 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $79.43 |
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | MS · Maintenance fee | $478.63 | $478.63 | $478.63 |
United Setting Professional Modifier UE · Used equipment Typical Low $776.25 Median $933.25 Typical High $1,737.80 | Professional | UE · Used equipment | $776.25 | $933.25 | $1,737.80 |
Where New Jersey 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.
New Jersey· 37th of 51
$912
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.