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 $1,905.46 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,905.46 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | KM · Facial prosthesis, new mold | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | KN · Facial prosthesis, prior mold | $467.74 | $467.74 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,818.38 | Professional | None | $2,137.96 | $2,137.96 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,754.23 | $2,754.23 | $3,235.94 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | KM · Facial prosthesis, new mold | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | KN · Facial prosthesis, prior mold | $1,288.25 | $1,288.25 | $1,288.25 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,884.03 Median $4,168.69 Typical High $6,165.95 | Professional | None | $2,884.03 | $4,168.69 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,884.03 Median $4,168.69 Typical High $6,165.95 | Professional | KM · Facial prosthesis, new mold | $2,884.03 | $4,168.69 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $2,884.03 Median $4,168.69 Typical High $6,165.95 | Professional | KN · Facial prosthesis, prior mold | $2,884.03 | $4,168.69 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,137.96 | $3,162.28 |
United Setting Professional Modifier RR · Rental Typical Low $741.31 Median $851.14 Typical High $1,288.25 | Professional | RR · Rental | $741.31 | $851.14 | $1,288.25 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,737.80 Median $2,041.74 Typical High $3,019.95 | Professional | UE · Used equipment | $1,737.80 | $2,041.74 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,187.76 | $3,548.13 |
1 more rate 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 $281.84 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $281.84 | $316.23 | $316.23 |
Where Maryland sits
The same service costs 2.2 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.
Maryland· 49th of 51
$2,188
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.