How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,950 to $19,055Professionalmedian $2,188 · 10th to 90th $1,622 to $3,548
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 $1,698.24 Median $2,511.89 Typical High $2,511.89 | Facility | None | $1,698.24 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,698.24 | $2,511.89 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $17,782.79 | Facility | None | $3,801.89 | $3,801.89 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,621.81 | $2,187.76 | $3,090.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $218.78 Median $218.78 Typical High $2,187.76 | Professional | RR · Rental | $218.78 | $218.78 | $2,187.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,584.89 Median $1,659.59 Typical High $2,630.27 | Professional | UE · Used equipment | $1,584.89 | $1,659.59 | $2,630.27 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,801.89 | Professional | None | $2,290.87 | $2,290.87 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,467.37 | Facility | None | $3,235.94 | $3,235.94 | $3,467.37 |
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 |
Medica Setting Facility Modifier None Typical Low $1,778.28 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,778.28 | $3,715.35 | $19,054.61 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $21,379.62 | Professional | None | $1,513.56 | $2,041.74 | $21,379.62 |
Medica Setting Professional Modifier RR · Rental Typical Low $602.56 Median $741.31 Typical High $1,096.48 | Professional | RR · Rental | $602.56 | $741.31 | $1,096.48 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $1,412.54 Median $1,778.28 Typical High $2,630.27 | Professional | UE · Used equipment | $1,412.54 | $1,778.28 | $2,630.27 |
United Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,862.09 | $2,754.23 |
United Setting Professional Modifier RR · Rental Typical Low $562.34 Median $741.31 Typical High $1,122.02 | Professional | RR · Rental | $562.34 | $741.31 | $1,122.02 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,348.96 Median $1,778.28 Typical High $2,630.27 | Professional | UE · Used equipment | $1,348.96 | $1,778.28 | $2,630.27 |
5 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 $257.04 Median $380.19 Typical High $537.03 | Professional | 55 · Aftercare only | $257.04 | $380.19 | $537.03 |
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 |
BCBS Kansas City Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,187.76 Median $2,187.76 Typical High $3,630.78 | Professional | KM · Facial prosthesis, new mold | $2,187.76 | $2,187.76 | $3,630.78 |
BCBS Kansas City Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $912.01 Median $912.01 Typical High $1,513.56 | Professional | KN · Facial prosthesis, prior mold | $912.01 | $912.01 | $1,513.56 |
Where Missouri 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.
Missouri· 47th of 51
$2,188
HI $4,677DC $2,138
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.