How much rates vary
Facilitymedian $3,388 · 10th to 90th $2,399 to $5,754Professionalmedian $2,399 · 10th to 90th $1,230 to $16,218
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 $1,380.38 Median $1,380.38 Typical High $6,309.57 | Facility | None | $1,380.38 | $1,380.38 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $6,309.57 | Professional | None | $1,380.38 | $1,380.38 | $6,309.57 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,318.26 Median $1,318.26 Typical High $6,025.60 | Professional | KM · Facial prosthesis, new mold | $1,318.26 | $1,318.26 | $6,025.60 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $549.54 Median $549.54 Typical High $2,511.89 | Professional | KN · Facial prosthesis, prior mold | $549.54 | $549.54 | $2,511.89 |
Aetna Setting Professional Modifier RR · Rental Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | RR · Rental | $851.14 | $851.14 | $851.14 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2,754.23 Median $3,019.95 Typical High $6,309.57 | Facility | None | $2,754.23 | $3,019.95 | $6,309.57 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $16,218.10 | Professional | None | $1,230.27 | $3,235.94 | $16,218.10 |
AllWays Health Partners Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,570.40 Median $3,090.30 Typical High $3,090.30 | Professional | KM · Facial prosthesis, new mold | $2,570.40 | $3,090.30 | $3,090.30 |
AllWays Health Partners Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,096.48 Median $1,288.25 Typical High $1,288.25 | Professional | KN · Facial prosthesis, prior mold | $1,096.48 | $1,288.25 | $1,288.25 |
AllWays Health Partners Setting Professional Modifier RR · Rental Typical Low $416.87 Median $630.96 Typical High $1,230.27 | Professional | RR · Rental | $416.87 | $630.96 | $1,230.27 |
AllWays Health Partners Setting Professional Modifier UE · Used equipment Typical Low $1,000.00 Median $1,479.11 Typical High $2,951.21 | Professional | UE · Used equipment | $1,000.00 | $1,479.11 | $2,951.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $3,548.13 Median $4,073.80 Typical High $5,495.41 | Facility | None | $3,548.13 | $4,073.80 | $5,495.41 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,995.26 | $1,995.26 | $3,467.37 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,230.27 Median $2,754.23 Typical High $2,884.03 | Professional | None | $1,230.27 | $2,754.23 | $2,884.03 |
Harvard Pilgrim Setting Professional Modifier RR · Rental Typical Low $416.87 Median $630.96 Typical High $1,230.27 | Professional | RR · Rental | $416.87 | $630.96 | $1,230.27 |
Harvard Pilgrim Setting Professional Modifier UE · Used equipment Typical Low $1,000.00 Median $1,479.11 Typical High $2,951.21 | Professional | UE · Used equipment | $1,000.00 | $1,479.11 | $2,951.21 |
Mass General Brigham Setting Facility Modifier None Typical Low $2,754.23 Median $3,019.95 Typical High $6,309.57 | Facility | None | $2,754.23 | $3,019.95 | $6,309.57 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $16,218.10 | Professional | None | $1,230.27 | $3,235.94 | $16,218.10 |
Mass General Brigham Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,570.40 Median $3,090.30 Typical High $3,090.30 | Professional | KM · Facial prosthesis, new mold | $2,570.40 | $3,090.30 | $3,090.30 |
Mass General Brigham Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,096.48 Median $1,288.25 Typical High $1,288.25 | Professional | KN · Facial prosthesis, prior mold | $1,096.48 | $1,288.25 | $1,288.25 |
Mass General Brigham Setting Professional Modifier RR · Rental Typical Low $416.87 Median $630.96 Typical High $1,230.27 | Professional | RR · Rental | $416.87 | $630.96 | $1,230.27 |
Mass General Brigham Setting Professional Modifier UE · Used equipment Typical Low $1,000.00 Median $1,479.11 Typical High $2,951.21 | Professional | UE · Used equipment | $1,000.00 | $1,479.11 | $2,951.21 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,047.13 | $1,584.89 | $3,090.30 |
United Setting Professional Modifier RR · Rental Typical Low $416.87 Median $630.96 Typical High $1,230.27 | Professional | RR · Rental | $416.87 | $630.96 | $1,230.27 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,000.00 Median $1,479.11 Typical High $2,951.21 | Professional | UE · Used equipment | $1,000.00 | $1,479.11 | $2,951.21 |
Well Sense Setting Facility Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $4,073.80 | Facility | None | $2,089.30 | $2,884.03 | $4,073.80 |
2 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 $208.93 Median $208.93 Typical High $954.99 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $630.96 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $630.96 |
Where Massachusetts sits
The same service costs 2.0 times more in Hawaii than in Washington, DC. 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.
Massachusetts· 8th of 51
$2,630
HI $3,236DC $1,585
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.