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 $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $1,000.00 Typical High $1,047.13 | Facility | None | $426.58 | $1,000.00 | $1,047.13 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $1,071.52 Typical High $1,949.84 | Professional | None | $457.09 | $1,071.52 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $2,290.87 | Facility | None | $933.25 | $933.25 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $8,128.31 | Professional | None | $794.33 | $794.33 | $8,128.31 |
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 $812.83 Median $1,023.29 Typical High $1,862.09 | Professional | None | $812.83 | $1,023.29 | $1,862.09 |
United Setting Professional Modifier RR · Rental Typical Low $323.59 Median $416.87 Typical High $741.31 | Professional | RR · Rental | $323.59 | $416.87 | $741.31 |
United Setting Professional Modifier UE · Used equipment Typical Low $776.25 Median $977.24 Typical High $1,778.28 | Professional | UE · Used equipment | $776.25 | $977.24 | $1,778.28 |
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 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
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 West Virginia 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.
West Virginia· 47th of 51
$832
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.