How much rates vary
Facilitymedian $3,631 · 10th to 90th $3,631 to $3,890Professionalmedian $3,090 · 10th to 90th $1,738 to $3,715
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 Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
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 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,630.78 | Professional | None | $3,090.30 | $3,090.30 | $3,630.78 |
United Setting Facility Modifier None Typical Low $4,677.35 Median $5,495.41 Typical High $5,495.41 | Facility | None | $4,677.35 | $5,495.41 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $3,090.30 | Professional | None | $1,348.96 | $2,238.72 | $3,090.30 |
United Setting Professional Modifier RR · Rental Typical Low $537.03 Median $891.25 Typical High $1,230.27 | Professional | RR · Rental | $537.03 | $891.25 | $1,230.27 |
11 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 $562.34 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $371.54 | $371.54 | $371.54 |
Aetna 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 |
Aetna 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 |
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 |
Cigna 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 |
Cigna 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 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $3,630.78 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $3,630.78 |
Cigna 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 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $2,089.30 Typical High $2,884.03 | Professional | UE · Used equipment | $1,288.25 | $2,089.30 | $2,884.03 |
Where Alabama sits
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.
Alabama· 23rd of 51
$3,090
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.