How much rates vary
Facilitymedian $4,571 · 10th to 90th $2,692 to $9,120Professionalmedian $2,692 · 10th to 90th $2,089 to $6,026
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 $1,621.81 Median $1,949.84 Typical High $2,818.38 | Facility | None | $1,621.81 | $1,949.84 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,949.84 | $1,949.84 | $2,818.38 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,096.48 Median $1,096.48 Typical High $1,548.82 | Professional | KM · Facial prosthesis, new mold | $1,096.48 | $1,096.48 | $1,548.82 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | KN · Facial prosthesis, prior mold | $467.74 | $467.74 | $645.65 |
Aetna Setting Professional Modifier RR · Rental Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | RR · Rental | $1,174.90 | $1,174.90 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $9,120.11 | Facility | None | $4,570.88 | $4,570.88 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $7,585.78 | Professional | None | $2,187.76 | $2,290.87 | $7,585.78 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,754.23 Median $3,801.89 Typical High $4,677.35 | Professional | KM · Facial prosthesis, new mold | $2,754.23 | $3,801.89 | $4,677.35 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,148.15 Median $1,584.89 Typical High $1,949.84 | Professional | KN · Facial prosthesis, prior mold | $1,148.15 | $1,584.89 | $1,949.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $218.78 Median $218.78 Typical High $478.63 | Professional | RR · Rental | $218.78 | $218.78 | $478.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,659.59 Median $1,659.59 Typical High $2,951.21 | Professional | UE · Used equipment | $1,659.59 | $1,659.59 | $2,951.21 |
CDPHP Setting Professional Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $3,715.35 | Professional | None | $1,479.11 | $3,548.13 | $3,715.35 |
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 Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | KM · Facial prosthesis, new mold | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | KN · Facial prosthesis, prior mold | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
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 |
Emblem Health Setting Facility Modifier None Typical Low $4,570.88 Median $7,413.10 Typical High $16,218.10 | Facility | None | $4,570.88 | $7,413.10 | $16,218.10 |
Emblem Health Setting Professional Modifier None Typical Low $2,951.21 Median $4,786.30 Typical High $7,943.28 | Professional | None | $2,951.21 | $4,786.30 | $7,943.28 |
Emblem Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,090.30 Median $4,677.35 Typical High $8,128.31 | Professional | KM · Facial prosthesis, new mold | $3,090.30 | $4,677.35 | $8,128.31 |
Emblem Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,288.25 Median $1,995.26 Typical High $3,388.44 | Professional | KN · Facial prosthesis, prior mold | $1,288.25 | $1,995.26 | $3,388.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $3,715.35 | Professional | None | $2,511.89 | $2,818.38 | $3,715.35 |
Excellus BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,398.83 Median $2,691.53 Typical High $3,548.13 | Professional | KM · Facial prosthesis, new mold | $2,398.83 | $2,691.53 | $3,548.13 |
Excellus BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,023.29 Median $1,122.02 Typical High $1,479.11 | Professional | KN · Facial prosthesis, prior mold | $1,023.29 | $1,122.02 | $1,479.11 |
MVP Health Care Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $6,606.93 | Professional | None | $2,754.23 | $2,754.23 | $6,606.93 |
MVP Health Care Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,630.27 Median $2,630.27 Typical High $6,918.31 | Professional | KM · Facial prosthesis, new mold | $2,630.27 | $2,630.27 | $6,918.31 |
MVP Health Care Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,096.48 Median $1,096.48 Typical High $2,884.03 | Professional | KN · Facial prosthesis, prior mold | $1,096.48 | $1,096.48 | $2,884.03 |
United Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,456.54 | Facility | None | $4,897.79 | $4,897.79 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,691.53 Typical High $3,019.95 | Professional | None | $1,479.11 | $2,691.53 | $3,019.95 |
United Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | KM · Facial prosthesis, new mold | $2,187.76 | $2,187.76 | $2,187.76 |
United Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | KN · Facial prosthesis, prior mold | $912.01 | $912.01 | $912.01 |
United Setting Professional Modifier RR · Rental Typical Low $588.84 Median $1,096.48 Typical High $1,202.26 | Professional | RR · Rental | $588.84 | $1,096.48 | $1,202.26 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,412.54 Median $2,570.40 Typical High $2,884.03 | Professional | UE · Used equipment | $1,412.54 | $2,570.40 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,344.23 | $2,691.53 | $2,691.53 |
Univera Setting Professional Modifier None Typical Low $1,513.56 Median $2,818.38 Typical High $3,715.35 | Professional | None | $1,513.56 | $2,818.38 | $3,715.35 |
Univera Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,445.44 Median $2,691.53 Typical High $3,548.13 | Professional | KM · Facial prosthesis, new mold | $1,445.44 | $2,691.53 | $3,548.13 |
Univera Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $616.60 Median $1,122.02 Typical High $1,479.11 | Professional | KN · Facial prosthesis, prior mold | $616.60 | $1,122.02 | $1,479.11 |
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 $288.40 Median $288.40 Typical High $416.87 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | MS · Maintenance fee | $1,174.90 | $1,174.90 | $1,174.90 |
Where New York 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.
New York· 37th of 51
$2,692
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.