How much rates vary
Facilitymedian $4,169 · 10th to 90th $3,236 to $8,913Professionalmedian $3,802 · 10th to 90th $2,042 to $6,166
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 $4,073.80 Median $4,073.80 Typical High $4,073.80 | Facility | None | $4,073.80 | $4,073.80 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $7,079.46 | Professional | None | $4,073.80 | $4,073.80 | $7,079.46 |
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 |
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 $4,168.69 Median $4,677.35 Typical High $6,760.83 | Facility | None | $4,168.69 | $4,677.35 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $4,168.69 Typical High $5,128.61 | Professional | None | $2,187.76 | $4,168.69 | $5,128.61 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,630.78 Median $3,890.45 Typical High $5,248.07 | Professional | KM · Facial prosthesis, new mold | $3,630.78 | $3,890.45 | $5,248.07 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,548.82 Median $1,659.59 Typical High $2,238.72 | Professional | KN · Facial prosthesis, prior mold | $1,548.82 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $218.78 Median $218.78 Typical High $616.60 | Professional | RR · Rental | $218.78 | $218.78 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $3,235.94 Median $8,317.64 Typical High $17,378.01 | Facility | None | $3,235.94 | $8,317.64 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $3,467.37 Typical High $7,762.47 | Professional | None | $2,754.23 | $3,467.37 | $7,762.47 |
DeanCare Setting Facility Modifier None Typical Low $1,174.90 Median $4,073.80 Typical High $4,677.35 | Facility | None | $1,174.90 | $4,073.80 | $4,677.35 |
DeanCare Setting Professional Modifier None Typical Low $2,344.23 Median $4,073.80 Typical High $4,897.79 | Professional | None | $2,344.23 | $4,073.80 | $4,897.79 |
Medica Setting Facility Modifier None Typical Low $1,995.26 Median $4,073.80 Typical High $19,054.61 | Facility | None | $1,995.26 | $4,073.80 | $19,054.61 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $21,379.62 | Professional | None | $1,905.46 | $2,691.53 | $21,379.62 |
Medica Setting Professional Modifier RR · Rental Typical Low $741.31 Median $1,071.52 Typical High $1,380.38 | Professional | RR · Rental | $741.31 | $1,071.52 | $1,380.38 |
Network Health Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Network Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $7,079.46 | Professional | None | $2,951.21 | $3,801.89 | $7,079.46 |
Network Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,754.23 Median $3,630.78 Typical High $6,760.83 | Professional | KM · Facial prosthesis, new mold | $2,754.23 | $3,630.78 | $6,760.83 |
Network Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,174.90 Median $1,513.56 Typical High $2,818.38 | Professional | KN · Facial prosthesis, prior mold | $1,174.90 | $1,513.56 | $2,818.38 |
Prevea360 Setting Facility Modifier None Typical Low $1,174.90 Median $4,073.80 Typical High $4,677.35 | Facility | None | $1,174.90 | $4,073.80 | $4,677.35 |
Prevea360 Setting Professional Modifier None Typical Low $2,344.23 Median $4,073.80 Typical High $4,168.69 | Professional | None | $2,344.23 | $4,073.80 | $4,168.69 |
Quartz Setting Professional Modifier None Typical Low $3,981.07 Median $5,754.40 Typical High $9,120.11 | Professional | None | $3,981.07 | $5,754.40 | $9,120.11 |
Quartz 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 |
Quartz 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 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Facility | None | $5,888.44 | $5,888.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,691.53 Typical High $3,467.37 | Professional | None | $1,513.56 | $2,691.53 | $3,467.37 |
United Setting Professional Modifier RR · Rental Typical Low $602.56 Median $1,071.52 Typical High $1,445.44 | Professional | RR · Rental | $602.56 | $1,071.52 | $1,445.44 |
6 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 $602.56 Median $602.56 Typical High $1,047.13 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $707.95 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $707.95 |
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 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,659.59 Median $1,659.59 Typical High $1,778.28 | Professional | UE · Used equipment | $1,659.59 | $1,659.59 | $1,778.28 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $2,570.40 Typical High $3,311.31 | Professional | UE · Used equipment | $1,778.28 | $2,570.40 | $3,311.31 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,412.54 Median $2,570.40 Typical High $3,388.44 | Professional | UE · Used equipment | $1,412.54 | $2,570.40 | $3,388.44 |
Where Wisconsin 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.
Wisconsin· 3rd of 51
$4,074
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.