How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,995 to $13,183Professionalmedian $3,090 · 10th to 90th $2,042 to $38,019
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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $7,943.28 Typical High $15,848.93 | Facility | None | $1,949.84 | $7,943.28 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $6,760.83 | Professional | None | $2,454.71 | $3,235.94 | $6,760.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | RR · Rental | $2,454.71 | $2,454.71 | $2,454.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | UE · Used equipment | $1,862.09 | $1,862.09 | $1,862.09 |
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 Typical Low $5,248.07 Median $9,772.37 Typical High $17,782.79 | Professional | None | $5,248.07 | $9,772.37 | $17,782.79 |
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 |
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 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $8,317.64 | Professional | None | $2,884.03 | $3,715.35 | $8,317.64 |
Lucent Health Setting Professional Modifier None Typical Low $24,547.09 Median $24,547.09 Typical High $38,018.94 | Professional | None | $24,547.09 | $24,547.09 | $38,018.94 |
Molina Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $1,348.96 Median $3,630.78 Typical High $4,786.30 | Facility | None | $1,348.96 | $3,630.78 | $4,786.30 |
Providence 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 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
United Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,495.41 | Facility | None | $4,677.35 | $4,677.35 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $6,025.60 | Professional | None | $1,949.84 | $2,454.71 | $6,025.60 |
United Setting Professional Modifier RR · Rental Typical Low $776.25 Median $831.76 Typical High $1,819.70 | Professional | RR · Rental | $776.25 | $831.76 | $1,819.70 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,819.70 Median $1,949.84 Typical High $4,365.16 | Professional | UE · Used equipment | $1,819.70 | $1,949.84 | $4,365.16 |
20 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 $363.08 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | KM · Facial prosthesis, new mold | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | KN · Facial prosthesis, prior mold | $977.24 | $977.24 | $977.24 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $5,011.87 Typical High $6,456.54 | Professional | KM · Facial prosthesis, new mold | $3,019.95 | $5,011.87 | $6,456.54 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,288.25 Median $2,089.30 Typical High $2,691.53 | Professional | KN · Facial prosthesis, prior mold | $1,288.25 | $2,089.30 | $2,691.53 |
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 $3,388.44 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna 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 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,162.28 Median $4,466.84 Typical High $12,022.64 | Professional | KM · Facial prosthesis, new mold | $3,162.28 | $4,466.84 | $12,022.64 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,348.96 Median $1,905.46 Typical High $5,128.61 | Professional | KN · Facial prosthesis, prior mold | $1,348.96 | $1,905.46 | $5,128.61 |
Providence 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 |
Providence 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 |
Providence Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $4,168.69 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $4,168.69 |
Providence Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,737.80 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,737.80 |
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 |
United Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,187.76 Median $3,162.28 Typical High $5,495.41 | Professional | KM · Facial prosthesis, new mold | $2,187.76 | $3,162.28 | $5,495.41 |
United Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $933.25 Median $1,318.26 Typical High $2,290.87 | Professional | KN · Facial prosthesis, prior mold | $933.25 | $1,318.26 | $2,290.87 |
Where California 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.
California· 19th of 51
$3,236
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.