How much rates vary
Facilitymedian $4,266 · 10th to 90th $2,344 to $10,233Professionalmedian $3,090 · 10th to 90th $2,042 to $7,413
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 $1,862.09 Median $3,090.30 Typical High $4,466.84 | Facility | None | $1,862.09 | $3,090.30 | $4,466.84 |
Aetna Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | KM · Facial prosthesis, new mold | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $588.84 | Facility | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $588.84 |
Aetna Setting Facility Modifier RR · Rental Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | RR · Rental | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $2,344.23 Typical High $3,801.89 | Professional | None (both parts) | $1,905.46 | $2,344.23 | $3,801.89 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $1,230.27 Typical High $2,290.87 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $1,230.27 | $2,290.87 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $977.24 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $977.24 |
Aetna Setting Professional Modifier RR · Rental Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | RR · Rental | $1,318.26 | $1,318.26 | $1,318.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $4,168.69 Median $4,570.88 Typical High $9,549.93 | Facility | None | $4,168.69 | $4,570.88 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $4,897.79 Typical High $24,547.09 | Professional | None (both parts) | $1,862.09 | $4,897.79 | $24,547.09 |
AllWays Health Partners Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,890.45 Median $4,677.35 Typical High $4,677.35 | Professional | KM · Facial prosthesis, new mold | $3,890.45 | $4,677.35 | $4,677.35 |
AllWays Health Partners Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,659.59 Median $1,949.84 Typical High $1,949.84 | Professional | KN · Facial prosthesis, prior mold | $1,659.59 | $1,949.84 | $1,949.84 |
AllWays Health Partners Setting Professional Modifier RR · Rental Typical Low $630.96 Median $954.99 Typical High $1,862.09 | Professional | RR · Rental | $630.96 | $954.99 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $2,290.87 Typical High $4,466.84 | Professional | UE · Used equipment | $1,513.56 | $2,290.87 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $13,182.57 | Facility | None | $3,235.94 | $5,370.32 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,454.71 Typical High $7,079.46 | Professional | None (both parts) | $2,137.96 | $2,454.71 | $7,079.46 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $5,011.87 Typical High $10,964.78 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $5,011.87 | $10,964.78 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $2,089.30 Typical High $4,570.88 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $2,089.30 | $4,570.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $245.47 Median $323.59 Typical High $2,454.71 | Professional | RR · Rental | $245.47 | $323.59 | $2,454.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,819.70 Median $1,862.09 Typical High $4,168.69 | Professional | UE · Used equipment | $1,819.70 | $1,862.09 | $4,168.69 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3,467.37 Median $4,365.16 Typical High $4,570.88 | Facility | None | $3,467.37 | $4,365.16 | $4,570.88 |
Asuris Northwest Health Setting Professional Modifier None (both parts) Typical Low $3,890.45 Median $24,547.09 Typical High $38,018.94 | Professional | None (both parts) | $3,890.45 | $24,547.09 | $38,018.94 |
Asuris Northwest Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,715.35 Typical High $4,570.88 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,715.35 | $4,570.88 |
Asuris Northwest Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,412.54 Median $1,548.82 Typical High $1,905.46 | Professional | KN · Facial prosthesis, prior mold | $1,412.54 | $1,548.82 | $1,905.46 |
AvMed Setting Facility Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,570.88 | $4,570.88 | $4,570.88 |
AvMed Setting Professional Modifier None (both parts) Typical Low $3,162.28 Median $3,890.45 Typical High $4,570.88 | Professional | None (both parts) | $3,162.28 | $3,890.45 | $4,570.88 |
AvMed Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,467.37 Median $3,801.89 Typical High $4,265.80 | Professional | KM · Facial prosthesis, new mold | $3,467.37 | $3,801.89 | $4,265.80 |
AvMed Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,584.89 Typical High $1,819.70 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,584.89 | $1,819.70 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,148.15 Median $5,248.07 Typical High $7,943.28 | Facility | None | $1,148.15 | $5,248.07 | $7,943.28 |
BCBS Arizona Setting Professional Modifier None (both parts) Typical Low $3,311.31 Median $3,801.89 Typical High $6,918.31 | Professional | None (both parts) | $3,311.31 | $3,801.89 | $6,918.31 |
BCBS Arkansas Setting Professional Modifier None (both parts) Typical Low $3,801.89 Median $4,168.69 Typical High $5,011.87 | Professional | None (both parts) | $3,801.89 | $4,168.69 | $5,011.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,235.94 Median $4,365.16 Typical High $7,244.36 | Facility | None | $3,235.94 | $4,365.16 | $7,244.36 |
BCBS Idaho Setting Professional Modifier None (both parts) Typical Low $3,162.28 Median $4,786.30 Typical High $5,011.87 | Professional | None (both parts) | $3,162.28 | $4,786.30 | $5,011.87 |
BCBS Idaho Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $4,570.88 Typical High $4,786.30 | Professional | KM · Facial prosthesis, new mold | $3,019.95 | $4,570.88 | $4,786.30 |
BCBS Idaho Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,288.25 Median $1,905.46 Typical High $1,995.26 | Professional | KN · Facial prosthesis, prior mold | $1,288.25 | $1,905.46 | $1,995.26 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $7,585.78 Typical High $31,622.78 | Facility | None | $5,495.41 | $7,585.78 | $31,622.78 |
BCBS Kansas Setting Facility Modifier None Typical Low $3,235.94 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,235.94 | $3,388.44 | $3,388.44 |
BCBS Kansas Setting Professional Modifier None (both parts) Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None (both parts) | $3,311.31 | $3,311.31 | $3,311.31 |
BCBS Kansas City Setting Professional Modifier None (both parts) Typical Low $2,570.40 Median $2,570.40 Typical High $4,265.80 | Professional | None (both parts) | $2,570.40 | $2,570.40 | $4,265.80 |
BCBS Kansas City Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,454.71 Median $2,454.71 Typical High $4,073.80 | Professional | KM · Facial prosthesis, new mold | $2,454.71 | $2,454.71 | $4,073.80 |
BCBS Kansas City Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,023.29 Median $1,023.29 Typical High $1,698.24 | Professional | KN · Facial prosthesis, prior mold | $1,023.29 | $1,023.29 | $1,698.24 |
BCBS Louisiana Setting Facility Modifier None Typical Low $3,801.89 Median $6,606.93 Typical High $9,332.54 | Facility | None | $3,801.89 | $6,606.93 | $9,332.54 |
BCBS Louisiana Setting Professional Modifier None (both parts) Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None (both parts) | $3,162.28 | $3,162.28 | $3,162.28 |
BCBS Louisiana 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 |
BCBS Louisiana Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | KN · Facial prosthesis, prior mold | $1,258.93 | $1,258.93 | $1,258.93 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $5,370.32 Median $6,165.95 Typical High $8,317.64 | Facility | None | $5,370.32 | $6,165.95 | $8,317.64 |
BCBS Massachusetts Setting Professional Modifier None (both parts) Typical Low $3,162.28 Median $4,365.16 Typical High $4,365.16 | Professional | None (both parts) | $3,162.28 | $4,365.16 | $4,365.16 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,495.41 Median $13,489.63 Typical High $25,118.86 | Facility | None | $5,495.41 | $13,489.63 | $25,118.86 |
BCBS Michigan Setting Professional Modifier None (both parts) Typical Low $4,265.80 Median $4,570.88 Typical High $4,570.88 | Professional | None (both parts) | $4,265.80 | $4,570.88 | $4,570.88 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $6,918.31 | Facility | None | $4,073.80 | $4,570.88 | $6,918.31 |
BCBS Mississippi Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
BCBS Mississippi Setting Professional Modifier None (both parts) Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None (both parts) | $3,467.37 | $3,467.37 | $3,467.37 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,570.40 Median $3,388.44 Typical High $4,570.88 | Professional | None (both parts) | $2,570.40 | $3,388.44 | $4,570.88 |
BCBS North Dakota Setting Professional Modifier None (both parts) Typical Low $3,630.78 Median $4,786.30 Typical High $4,786.30 | Professional | None (both parts) | $3,630.78 | $4,786.30 | $4,786.30 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $6,918.31 Median $9,549.93 Typical High $11,220.18 | Facility | None | $6,918.31 | $9,549.93 | $11,220.18 |
BCBS Rhode Island Setting Professional Modifier None (both parts) Typical Low $1,778.28 Median $2,511.89 Typical High $4,073.80 | Professional | None (both parts) | $1,778.28 | $2,511.89 | $4,073.80 |
BCBS South Carolina Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,073.80 | $4,570.88 | $4,570.88 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None (both parts) | $4,570.88 | $4,570.88 | $4,570.88 |
BCBS South Carolina Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | KM · Facial prosthesis, new mold | $4,265.80 | $4,265.80 | $4,265.80 |
BCBS South Carolina Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | KN · Facial prosthesis, prior mold | $1,819.70 | $1,819.70 | $1,819.70 |
BCBS Tennessee Setting Professional Modifier None (both parts) Typical Low $2,630.27 Median $3,388.44 Typical High $3,388.44 | Professional | None (both parts) | $2,630.27 | $3,388.44 | $3,388.44 |
BCBS Tennessee Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,511.89 Median $3,235.94 Typical High $3,235.94 | Professional | KM · Facial prosthesis, new mold | $2,511.89 | $3,235.94 | $3,235.94 |
BCBS Tennessee Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,071.52 Median $1,348.96 Typical High $1,348.96 | Professional | KN · Facial prosthesis, prior mold | $1,071.52 | $1,348.96 | $1,348.96 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None (both parts) | $2,630.27 | $2,630.27 | $2,630.27 |
Blue Shield Setting Facility Modifier None Typical Low $2,818.38 Median $6,918.31 Typical High $11,481.54 | Facility | None | $2,818.38 | $6,918.31 | $11,481.54 |
Blue Shield Setting Professional Modifier None (both parts) Typical Low $5,248.07 Median $9,772.37 Typical High $17,782.79 | Professional | None (both parts) | $5,248.07 | $9,772.37 | $17,782.79 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $3,890.45 Typical High $4,168.69 | Professional | None (both parts) | $1,659.59 | $3,890.45 | $4,168.69 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None (both parts) Typical Low $3,467.37 Median $3,467.37 Typical High $3,715.35 | Professional | None (both parts) | $3,467.37 | $3,467.37 | $3,715.35 |
Capital Blue Cross Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,467.37 Median $4,365.16 Typical High $4,365.16 | Professional | KM · Facial prosthesis, new mold | $3,467.37 | $4,365.16 | $4,365.16 |
Capital Blue Cross Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,819.70 Typical High $1,819.70 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,819.70 | $1,819.70 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $2,398.83 Median $2,398.83 Typical High $3,162.28 | Professional | None (both parts) | $2,398.83 | $2,398.83 | $3,162.28 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $2,884.03 Typical High $6,165.95 | Facility | None | $1,348.96 | $2,884.03 | $6,165.95 |
CareSource Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $4,466.84 Typical High $6,456.54 | Professional | None (both parts) | $1,905.46 | $4,466.84 | $6,456.54 |
Christus Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,677.35 | Facility | None | $3,630.78 | $3,630.78 | $4,677.35 |
Cigna Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $3,630.78 | Facility | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $3,630.78 |
Cigna Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,513.56 | Facility | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,513.56 |
Cigna Setting Professional Modifier None (both parts) Typical Low $3,090.30 Median $3,090.30 Typical High $5,248.07 | Professional | None (both parts) | $3,090.30 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $4,265.80 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,778.28 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,778.28 |
ConnectiCare Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Facility | None | $3,090.30 | $3,090.30 | $3,090.30 |
ConnectiCare Setting Professional Modifier None (both parts) Typical Low $3,090.30 Median $3,311.31 Typical High $5,623.41 | Professional | None (both parts) | $3,090.30 | $3,311.31 | $5,623.41 |
Contra Costa Health Setting Professional Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $5,754.40 | Professional | None | $3,801.89 | $5,248.07 | $5,754.40 |
DeanCare Setting Facility Modifier None Typical Low $1,318.26 Median $4,570.88 Typical High $5,248.07 | Facility | None | $1,318.26 | $4,570.88 | $5,248.07 |
DeanCare Setting Professional Modifier None (both parts) Typical Low $2,570.40 Median $4,570.88 Typical High $5,495.41 | Professional | None (both parts) | $2,570.40 | $4,570.88 | $5,495.41 |
Denver HMP Setting Facility Modifier None Typical Low $1,318.26 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,318.26 | $2,570.40 | $5,128.61 |
Denver HMP Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None (both parts) | $1,318.26 | $1,318.26 | $1,318.26 |
Emblem Health Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $18,197.01 | Facility | None | $5,011.87 | $8,317.64 | $18,197.01 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $3,311.31 Median $5,623.41 Typical High $8,511.38 | Professional | None (both parts) | $3,311.31 | $5,623.41 | $8,511.38 |
Emblem Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,466.84 Median $6,025.60 Typical High $8,709.64 | Professional | KM · Facial prosthesis, new mold | $4,466.84 | $6,025.60 | $8,709.64 |
Emblem Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,862.09 Median $2,511.89 Typical High $3,715.35 | Professional | KN · Facial prosthesis, prior mold | $1,862.09 | $2,511.89 | $3,715.35 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $2,818.38 Median $3,162.28 Typical High $4,168.69 | Professional | None (both parts) | $2,818.38 | $3,162.28 | $4,168.69 |
Excellus BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,691.53 Median $3,019.95 Typical High $3,890.45 | Professional | KM · Facial prosthesis, new mold | $2,691.53 | $3,019.95 | $3,890.45 |
Excellus BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,148.15 Median $1,258.93 Typical High $1,659.59 | Professional | KN · Facial prosthesis, prior mold | $1,148.15 | $1,258.93 | $1,659.59 |
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 |
Florida Blue Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Facility | None | $8,317.64 | $8,317.64 | $8,317.64 |
Florida Blue Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | KM · Facial prosthesis, new mold | $7,943.28 | $7,943.28 | $7,943.28 |
Florida Blue Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | KN · Facial prosthesis, prior mold | $3,388.44 | $3,388.44 | $3,388.44 |
Florida Blue Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $4,570.88 Typical High $4,570.88 | Professional | None (both parts) | $1,949.84 | $4,570.88 | $4,570.88 |
Florida Blue Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,570.40 Median $4,265.80 Typical High $4,265.80 | Professional | KM · Facial prosthesis, new mold | $2,570.40 | $4,265.80 | $4,265.80 |
Geisinger Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $2,398.83 Median $2,818.38 Typical High $4,677.35 | Professional | None (both parts) | $2,398.83 | $2,818.38 | $4,677.35 |
Geisinger Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,290.87 Median $2,630.27 Typical High $4,365.16 | Professional | KM · Facial prosthesis, new mold | $2,290.87 | $2,630.27 | $4,365.16 |
Geisinger Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $954.99 Median $1,122.02 Typical High $1,862.09 | Professional | KN · Facial prosthesis, prior mold | $954.99 | $1,122.02 | $1,862.09 |
HMSA Setting Professional Modifier None (both parts) Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None (both parts) | $4,897.79 | $4,897.79 | $4,897.79 |
HMSA Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | KM · Facial prosthesis, new mold | $4,677.35 | $4,677.35 | $4,677.35 |
HMSA Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | KN · Facial prosthesis, prior mold | $1,949.84 | $1,949.84 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $3,890.45 Median $4,570.88 Typical High $6,309.57 | Professional | None | $3,890.45 | $4,570.88 | $6,309.57 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None (both parts) Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None (both parts) | $5,888.44 | $5,888.44 | $5,888.44 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $4,168.69 Typical High $4,677.35 | Professional | None (both parts) | $1,862.09 | $4,168.69 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier RR · Rental Typical Low $630.96 Median $954.99 Typical High $1,862.09 | Professional | RR · Rental | $630.96 | $954.99 | $1,862.09 |
Harvard Pilgrim Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $2,290.87 Typical High $4,466.84 | Professional | UE · Used equipment | $1,513.56 | $2,290.87 | $4,466.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $8,912.51 Typical High $9,549.93 | Facility | None | $2,570.40 | $8,912.51 | $9,549.93 |
Health Alliance Plan Setting Professional Modifier None (both parts) Typical Low $2,344.23 Median $3,630.78 Typical High $4,677.35 | Professional | None (both parts) | $2,344.23 | $3,630.78 | $4,677.35 |
Health Alliance Plan Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $3,467.37 Typical High $4,365.16 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $3,467.37 | $4,365.16 |
Health Alliance Plan Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $1,445.44 Typical High $1,862.09 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $1,445.44 | $1,862.09 |
Health Partners Setting Facility Modifier None Typical Low $10,000.00 Median $15,848.93 Typical High $37,153.52 | Facility | None | $10,000.00 | $15,848.93 | $37,153.52 |
Health Partners Setting Professional Modifier None (both parts) Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None (both parts) | $5,248.07 | $5,248.07 | $5,248.07 |
Hometown Health Setting Professional Modifier None Typical Low $2,754.23 Median $4,265.80 Typical High $8,128.31 | Professional | None | $2,754.23 | $4,265.80 | $8,128.31 |
Horizon BCBS Setting Professional Modifier None (both parts) Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None (both parts) | $3,311.31 | $3,311.31 | $3,311.31 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None (both parts) Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None (both parts) | $4,677.35 | $4,677.35 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,162.28 Median $4,677.35 Typical High $9,120.11 | Professional | None | $3,162.28 | $4,677.35 | $9,120.11 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,090.30 Median $4,677.35 Typical High $7,943.28 | Professional | KM · Facial prosthesis, new mold | $3,090.30 | $4,677.35 | $7,943.28 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,348.96 Median $2,511.89 Typical High $5,495.41 | Professional | KN · Facial prosthesis, prior mold | $1,348.96 | $2,511.89 | $5,495.41 |
Kaiser Permanente Setting Facility Modifier None Typical Low $1,949.84 Median $4,677.35 Typical High $7,413.10 | Facility | None | $1,949.84 | $4,677.35 | $7,413.10 |
Kaiser Permanente Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $4,677.35 Typical High $7,585.78 | Professional | None (both parts) | $1,949.84 | $4,677.35 | $7,585.78 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $24,547.09 Median $24,547.09 Typical High $38,018.94 | Professional | None (both parts) | $24,547.09 | $24,547.09 | $38,018.94 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $3,090.30 Median $3,090.30 Typical High $7,413.10 | Professional | None (both parts) | $3,090.30 | $3,090.30 | $7,413.10 |
MVP Health Care Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,884.03 Median $2,884.03 Typical High $7,762.47 | Professional | KM · Facial prosthesis, new mold | $2,884.03 | $2,884.03 | $7,762.47 |
MVP Health Care Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,230.27 Median $1,230.27 Typical High $3,235.94 | Professional | KN · Facial prosthesis, prior mold | $1,230.27 | $1,230.27 | $3,235.94 |
Martin's Point Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,137.96 Typical High $2,454.71 | Professional | None (both parts) | $2,041.74 | $2,137.96 | $2,454.71 |
Martin's Point Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $1,230.27 | $1,230.27 |
Martin's Point Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $524.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $4,168.69 Median $4,570.88 Typical High $9,549.93 | Facility | None | $4,168.69 | $4,570.88 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None (both parts) Typical Low $1,862.09 Median $4,897.79 Typical High $24,547.09 | Professional | None (both parts) | $1,862.09 | $4,897.79 | $24,547.09 |
Mass General Brigham Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,890.45 Median $4,677.35 Typical High $4,677.35 | Professional | KM · Facial prosthesis, new mold | $3,890.45 | $4,677.35 | $4,677.35 |
Mass General Brigham Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,659.59 Median $1,949.84 Typical High $1,949.84 | Professional | KN · Facial prosthesis, prior mold | $1,659.59 | $1,949.84 | $1,949.84 |
Mass General Brigham Setting Professional Modifier RR · Rental Typical Low $630.96 Median $954.99 Typical High $1,862.09 | Professional | RR · Rental | $630.96 | $954.99 | $1,862.09 |
Mass General Brigham Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $2,290.87 Typical High $4,466.84 | Professional | UE · Used equipment | $1,513.56 | $2,290.87 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $4,265.80 | Professional | None | $2,187.76 | $3,019.95 | $4,265.80 |
Medcost Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,089.30 Median $2,884.03 Typical High $4,073.80 | Professional | KM · Facial prosthesis, new mold | $2,089.30 | $2,884.03 | $4,073.80 |
Medcost Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $870.96 Median $1,230.27 Typical High $1,698.24 | Professional | KN · Facial prosthesis, prior mold | $870.96 | $1,230.27 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $4,570.88 | Facility | None | $1,318.26 | $2,511.89 | $4,570.88 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,511.89 Median $3,090.30 Typical High $5,370.32 | Professional | None (both parts) | $2,511.89 | $3,090.30 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $2,238.72 Median $4,570.88 Typical High $21,379.62 | Facility | None | $2,238.72 | $4,570.88 | $21,379.62 |
Medica Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $2,884.03 Typical High $23,988.33 | Professional | None (both parts) | $1,819.70 | $2,884.03 | $23,988.33 |
Medica Setting Professional Modifier RR · Rental Typical Low $676.08 Median $831.76 Typical High $1,318.26 | Professional | RR · Rental | $676.08 | $831.76 | $1,318.26 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $1,584.89 Median $1,995.26 Typical High $3,090.30 | Professional | UE · Used equipment | $1,584.89 | $1,995.26 | $3,090.30 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $3,388.44 |
Medical Mutual of Ohio Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,445.44 |
Medical Mutual of Ohio Setting Professional Modifier None (both parts) Typical Low $3,090.30 Median $3,090.30 Typical High $3,630.78 | Professional | None (both parts) | $3,090.30 | $3,090.30 | $3,630.78 |
Medical Mutual of Ohio Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $3,388.44 |
Medical Mutual of Ohio Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $4,570.88 Median $5,754.40 Typical High $6,025.60 | Professional | None | $4,570.88 | $5,754.40 | $6,025.60 |
Midlands Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Midlands Setting Professional Modifier None (both parts) Typical Low $3,801.89 Median $6,918.31 Typical High $10,471.29 | Professional | None (both parts) | $3,801.89 | $6,918.31 | $10,471.29 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,951.21 Typical High $4,466.84 | Facility | None | $1,318.26 | $2,951.21 | $4,466.84 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $3,388.44 Typical High $4,570.88 | Professional | None (both parts) | $1,905.46 | $3,388.44 | $4,570.88 |
Moda Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $1,230.27 Typical High $4,466.84 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $1,230.27 | $4,466.84 |
Moda Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $1,862.09 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $1,862.09 |
Molina Setting Professional Modifier None (both parts) Typical Low $81.28 Median $2,884.03 Typical High $4,365.16 | Professional | None (both parts) | $81.28 | $2,884.03 | $4,365.16 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,311.31 Median $5,495.41 Typical High $269,153.48 | Facility | None | $3,311.31 | $5,495.41 | $269,153.48 |
MountainHealth Co-op Setting Professional Modifier None (both parts) Typical Low $4,365.16 Median $5,370.32 Typical High $323,593.66 | Professional | None (both parts) | $4,365.16 | $5,370.32 | $323,593.66 |
MountainHealth Co-op Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,235.94 Median $4,570.88 Typical High $4,570.88 | Professional | KM · Facial prosthesis, new mold | $3,235.94 | $4,570.88 | $4,570.88 |
MountainHealth Co-op Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,380.38 Median $1,905.46 Typical High $1,905.46 | Professional | KN · Facial prosthesis, prior mold | $1,380.38 | $1,905.46 | $1,905.46 |
Network Health Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Network Health Setting Professional Modifier None (both parts) Typical Low $3,311.31 Median $4,265.80 Typical High $7,943.28 | Professional | None (both parts) | $3,311.31 | $4,265.80 | $7,943.28 |
Network Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,090.30 Median $4,073.80 Typical High $7,585.78 | Professional | KM · Facial prosthesis, new mold | $3,090.30 | $4,073.80 | $7,585.78 |
Network Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,318.26 Median $1,698.24 Typical High $3,162.28 | Professional | KN · Facial prosthesis, prior mold | $1,318.26 | $1,698.24 | $3,162.28 |
Optum Setting Professional Modifier None (both parts) Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None (both parts) | $54.95 | $54.95 | $70.79 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $4,570.88 Median $7,079.46 Typical High $7,585.78 | Professional | None (both parts) | $4,570.88 | $7,079.46 | $7,585.78 |
Pacific Source Setting Facility Modifier None Typical Low $3,548.13 Median $4,265.80 Typical High $4,466.84 | Facility | None | $3,548.13 | $4,265.80 | $4,466.84 |
Pacific Source Setting Professional Modifier None (both parts) Typical Low $4,265.80 Median $4,466.84 Typical High $4,466.84 | Professional | None (both parts) | $4,265.80 | $4,466.84 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $14,125.38 | Facility | None | $912.01 | $2,089.30 | $14,125.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None (both parts) Typical Low $2,884.03 Median $3,801.89 Typical High $5,623.41 | Professional | None (both parts) | $2,884.03 | $3,801.89 | $5,623.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,754.23 Median $3,630.78 Typical High $5,370.32 | Professional | KM · Facial prosthesis, new mold | $2,754.23 | $3,630.78 | $5,370.32 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,148.15 Median $1,513.56 Typical High $2,238.72 | Professional | KN · Facial prosthesis, prior mold | $1,148.15 | $1,513.56 | $2,238.72 |
Premera BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $8,709.64 | Facility | None | $3,890.45 | $3,890.45 | $8,709.64 |
Premera BCBS Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,715.35 Median $3,715.35 Typical High $8,317.64 | Facility | KM · Facial prosthesis, new mold | $3,715.35 | $3,715.35 | $8,317.64 |
Premera BCBS Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,548.82 Median $1,548.82 Typical High $3,467.37 | Facility | KN · Facial prosthesis, prior mold | $1,548.82 | $1,548.82 | $3,467.37 |
Premera BCBS Setting Professional Modifier None (both parts) Typical Low $3,715.35 Median $3,715.35 Typical High $4,897.79 | Professional | None (both parts) | $3,715.35 | $3,715.35 | $4,897.79 |
Premera BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,548.13 Median $3,548.13 Typical High $4,677.35 | Professional | KM · Facial prosthesis, new mold | $3,548.13 | $3,548.13 | $4,677.35 |
Premera BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,479.11 Median $1,479.11 Typical High $2,041.74 | Professional | KN · Facial prosthesis, prior mold | $1,479.11 | $1,479.11 | $2,041.74 |
Prevea360 Setting Facility Modifier None Typical Low $1,318.26 Median $4,570.88 Typical High $5,248.07 | Facility | None | $1,318.26 | $4,570.88 | $5,248.07 |
Prevea360 Setting Professional Modifier None (both parts) Typical Low $2,570.40 Median $4,570.88 Typical High $4,677.35 | Professional | None (both parts) | $2,570.40 | $4,570.88 | $4,677.35 |
Priority Health 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 |
Priority Health Setting Professional Modifier None (both parts) Typical Low $3,019.95 Median $3,630.78 Typical High $4,570.88 | Professional | None (both parts) | $3,019.95 | $3,630.78 | $4,570.88 |
Priority Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $3,548.13 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $3,548.13 |
Priority Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,513.56 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $1,905.46 Median $3,630.78 Typical High $4,466.84 | Facility | None | $1,905.46 | $3,630.78 | $4,466.84 |
Providence Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $3,630.78 | Facility | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $3,630.78 |
Providence Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,548.82 | Facility | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,548.82 |
Providence Setting Professional Modifier None (both parts) Typical Low $3,090.30 Median $3,090.30 Typical High $4,265.80 | Professional | None (both parts) | $3,090.30 | $3,090.30 | $4,265.80 |
Providence Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $4,265.80 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $4,265.80 |
Providence Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,778.28 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,778.28 |
Quartz Setting Professional Modifier None Typical Low $4,466.84 Median $6,456.54 Typical High $10,232.93 | Professional | None | $4,466.84 | $6,456.54 | $10,232.93 |
Quartz 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 |
Quartz Setting Professional Modifier None (both parts) Typical Low $3,090.30 Median $3,090.30 Typical High $3,630.78 | Professional | None (both parts) | $3,090.30 | $3,090.30 | $3,630.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $14,791.08 | Facility | None | $3,890.45 | $4,365.16 | $14,791.08 |
Regence BlueShield Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,715.35 Median $4,168.69 Typical High $14,125.38 | Facility | KM · Facial prosthesis, new mold | $3,715.35 | $4,168.69 | $14,125.38 |
Regence BlueShield Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,548.82 Median $1,737.80 Typical High $5,888.44 | Facility | KN · Facial prosthesis, prior mold | $1,548.82 | $1,737.80 | $5,888.44 |
Regence BlueShield Setting Professional Modifier None (both parts) Typical Low $3,019.95 Median $3,890.45 Typical High $5,011.87 | Professional | None (both parts) | $3,019.95 | $3,890.45 | $5,011.87 |
Regence BlueShield Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,884.03 Median $3,715.35 Typical High $4,786.30 | Professional | KM · Facial prosthesis, new mold | $2,884.03 | $3,715.35 | $4,786.30 |
Regence BlueShield Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,230.27 Median $1,548.82 Typical High $1,995.26 | Professional | KN · Facial prosthesis, prior mold | $1,230.27 | $1,548.82 | $1,995.26 |
Sanford Health Plan Setting Professional Modifier None Typical Low $3,630.78 Median $4,265.80 Typical High $5,011.87 | Professional | None | $3,630.78 | $4,265.80 | $5,011.87 |
Select Health Setting Facility Modifier None Typical Low $4,265.80 Median $4,570.88 Typical High $8,128.31 | Facility | None | $4,265.80 | $4,570.88 | $8,128.31 |
Select Health Setting Professional Modifier None (both parts) Typical Low $3,019.95 Median $4,365.16 Typical High $5,011.87 | Professional | None (both parts) | $3,019.95 | $4,365.16 | $5,011.87 |
Select Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,884.03 Median $4,168.69 Typical High $4,786.30 | Professional | KM · Facial prosthesis, new mold | $2,884.03 | $4,168.69 | $4,786.30 |
Select Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,230.27 Median $1,737.80 Typical High $1,995.26 | Professional | KN · Facial prosthesis, prior mold | $1,230.27 | $1,737.80 | $1,995.26 |
Sentara Setting Facility Modifier None Typical Low $1,202.26 Median $3,019.95 Typical High $7,079.46 | Facility | None | $1,202.26 | $3,019.95 | $7,079.46 |
Sentara Setting Professional Modifier None (both parts) Typical Low $1,258.93 Median $3,019.95 Typical High $6,025.60 | Professional | None (both parts) | $1,258.93 | $3,019.95 | $6,025.60 |
Sentara Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,511.89 Median $3,235.94 Typical High $5,754.40 | Professional | KM · Facial prosthesis, new mold | $2,511.89 | $3,235.94 | $5,754.40 |
Sentara Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,071.52 Median $1,380.38 Typical High $2,398.83 | Professional | KN · Facial prosthesis, prior mold | $1,071.52 | $1,380.38 | $2,398.83 |
SummaCare Setting Professional Modifier None (both parts) Typical Low $4,677.35 Median $4,677.35 Typical High $7,244.36 | Professional | None (both parts) | $4,677.35 | $4,677.35 | $7,244.36 |
SummaCare Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,365.16 Median $4,466.84 Typical High $6,918.31 | Professional | KM · Facial prosthesis, new mold | $4,365.16 | $4,466.84 | $6,918.31 |
SummaCare Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,862.09 Median $1,862.09 Typical High $2,951.21 | Professional | KN · Facial prosthesis, prior mold | $1,862.09 | $1,862.09 | $2,951.21 |
Sutter Health Plus Setting Professional Modifier None (both parts) Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None (both parts) | $8,912.51 | $8,912.51 | $8,912.51 |
Sutter Health Plus Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | KM · Facial prosthesis, new mold | $8,317.64 | $8,317.64 | $8,317.64 |
Sutter Health Plus Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | KN · Facial prosthesis, prior mold | $3,548.13 | $3,548.13 | $3,548.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $5,495.41 | Professional | None | $2,691.53 | $3,467.37 | $5,495.41 |
UPMC Health Plan Setting Facility Modifier None Typical Low $3,235.94 Median $14,791.08 Typical High $25,703.96 | Facility | None | $3,235.94 | $14,791.08 | $25,703.96 |
UPMC Health Plan Setting Professional Modifier None (both parts) Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Professional | None (both parts) | $3,235.94 | $3,235.94 | $4,365.16 |
UPMC Health Plan Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | KM · Facial prosthesis, new mold | $4,073.80 | $4,073.80 | $4,073.80 |
UPMC Health Plan Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | KN · Facial prosthesis, prior mold | $1,737.80 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $4,677.35 Median $5,495.41 Typical High $6,606.93 | Facility | None | $4,677.35 | $5,495.41 | $6,606.93 |
United Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $2,344.23 Typical High $3,981.07 | Professional | None (both parts) | $1,698.24 | $2,344.23 | $3,981.07 |
United Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,290.87 Median $3,162.28 Typical High $5,495.41 | Professional | KM · Facial prosthesis, new mold | $2,290.87 | $3,162.28 | $5,495.41 |
United Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $977.24 Median $1,318.26 Typical High $2,290.87 | Professional | KN · Facial prosthesis, prior mold | $977.24 | $1,318.26 | $2,290.87 |
United Setting Professional Modifier RR · Rental Typical Low $676.08 Median $912.01 Typical High $1,348.96 | Professional | RR · Rental | $676.08 | $912.01 | $1,348.96 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,584.89 Median $2,137.96 Typical High $3,235.94 | Professional | UE · Used equipment | $1,584.89 | $2,137.96 | $3,235.94 |
Univera Setting Facility Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $3,019.95 | Facility | None | $2,630.27 | $3,019.95 | $3,019.95 |
Univera Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $3,162.28 Typical High $4,168.69 | Professional | None (both parts) | $1,698.24 | $3,162.28 | $4,168.69 |
Univera Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,621.81 Median $3,019.95 Typical High $3,890.45 | Professional | KM · Facial prosthesis, new mold | $1,621.81 | $3,019.95 | $3,890.45 |
Univera Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $676.08 Median $1,258.93 Typical High $1,659.59 | Professional | KN · Facial prosthesis, prior mold | $676.08 | $1,258.93 | $1,659.59 |
University Health Alliance Setting Professional Modifier None (both parts) Typical Low $3,890.45 Median $3,981.07 Typical High $4,570.88 | Professional | None (both parts) | $3,890.45 | $3,981.07 | $4,570.88 |
Well Sense Setting Facility Modifier None Typical Low $3,162.28 Median $4,365.16 Typical High $6,165.95 | Facility | None | $3,162.28 | $4,365.16 | $6,165.95 |
Wellmark Setting Professional Modifier None (both parts) Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None (both parts) | $4,168.69 | $4,168.69 | $4,168.69 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $2,454.71 Typical High $4,466.84 | Professional | None (both parts) | $2,454.71 | $2,454.71 | $4,466.84 |
28 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 Facility Modifier 55 · Aftercare only Typical Low $275.42 Median $467.74 Typical High $660.69 | Facility | 55 · Aftercare only | $275.42 | $467.74 | $660.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $131.83 Median $234.42 Typical High $457.09 | Facility | 56 · Pre-op care only | $131.83 | $234.42 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $346.74 Typical High $575.44 | Professional | 55 · Aftercare only | $288.40 | $346.74 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $234.42 Typical High $446.68 | Professional | 56 · Pre-op care only | $186.21 | $234.42 | $446.68 |
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | MS · Maintenance fee | $1,318.26 | $1,318.26 | $1,318.26 |
BCBS Alabama Setting Professional Modifier 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $3,311.31 | $3,311.31 | $3,311.31 |
BCBS Arkansas Setting Professional Modifier TC · Technical part Typical Low $3,630.78 Median $3,981.07 Typical High $4,786.30 | Professional | TC · Technical part | $3,630.78 | $3,981.07 | $4,786.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $3,388.44 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,951.21 | $3,388.44 | $3,548.13 |
BCBS Minnesota Setting Professional Modifier KM · Facial prosthesis, new mold + KN · Facial prosthesis, prior mold Typical Low $3,715.35 Median $4,677.35 Typical High $4,677.35 | Professional | KM · Facial prosthesis, new mold + KN · Facial prosthesis, prior mold | $3,715.35 | $4,677.35 | $4,677.35 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $4,365.16 Median $5,754.40 Typical High $5,754.40 | Professional | 22 · Increased work | $4,365.16 | $5,754.40 | $5,754.40 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 53 · Discontinued | $2,951.21 | $2,951.21 | $2,951.21 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $4,073.80 Median $4,570.88 Typical High $4,570.88 | Professional | 50 · Both sides | $4,073.80 | $4,570.88 | $4,570.88 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $389.05 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $323.59 Typical High $363.08 | Professional | 55 · Aftercare only | $302.00 | $323.59 | $363.08 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,258.93 Median $1,348.96 Typical High $3,019.95 | Professional | 26 · Professional part | $1,258.93 | $1,348.96 | $3,019.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $4,677.35 Typical High $11,748.98 | Professional | 50 · Both sides | $3,715.35 | $4,677.35 | $11,748.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,230.27 Median $1,548.82 Typical High $3,981.07 | Professional | 51 · Multiple procedures | $1,230.27 | $1,548.82 | $3,981.07 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $630.96 Typical High $1,584.89 | Professional | 80 · Assistant surgeon | $501.19 | $630.96 | $1,584.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $436.52 Typical High $1,096.48 | Professional | 81 · Minimal assistant surgeon | $346.74 | $436.52 | $1,096.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $436.52 Typical High $1,096.48 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $436.52 | $1,096.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $436.52 Typical High $1,096.48 | Professional | AS · PA/NP assist | $346.74 | $436.52 | $1,096.48 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | SH · Second concurrent infusion | $1,230.27 | $1,230.27 | $1,230.27 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | SJ · Third+ concurrent infusion | $1,230.27 | $1,230.27 | $1,230.27 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,862.09 Median $1,995.26 Typical High $4,466.84 | Professional | TC · Technical part | $1,862.09 | $1,995.26 | $4,466.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $562.34 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $562.34 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $288.40 Typical High $436.52 | Professional | 56 · Pre-op care only | $194.98 | $288.40 | $436.52 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | NR · New when rented | $3,890.45 | $3,890.45 | $3,890.45 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $3,715.35 Median $3,715.35 Typical High $4,897.79 | Professional | NR · New when rented | $3,715.35 | $3,715.35 | $4,897.79 |
What it costs in each state
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.
Touch or drag across the chart to see any state's rate.
HI $4,898DC $2,399
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.