How much rates vary
Facilitymedian $8,318 · 10th to 90th $3,631 to $8,318Professionalmedian $2,455 · 10th to 90th $1,905 to $4,571
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 $1,905.46 Median $1,905.46 Typical High $2,344.23 | Facility | None | $1,905.46 | $1,905.46 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,905.46 | $2,041.74 | $2,398.83 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $1,230.27 Typical High $2,238.72 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $1,230.27 | $2,238.72 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $933.25 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $933.25 |
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 |
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 Typical Low $3,162.28 Median $3,890.45 Typical High $4,570.88 | Professional | None | $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 |
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 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 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 |
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 |
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 Typical Low $1,949.84 Median $4,570.88 Typical High $4,570.88 | Professional | None | $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 |
Molina Setting Professional Modifier None Typical Low $1,445.44 Median $3,467.37 Typical High $3,630.78 | Professional | None | $1,445.44 | $3,467.37 | $3,630.78 |
United Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
United Setting Professional Modifier None Typical Low $60.26 Median $2,238.72 Typical High $3,019.95 | Professional | None | $60.26 | $2,238.72 | $3,019.95 |
United Setting Professional Modifier RR · Rental Typical Low $758.58 Median $891.25 Typical High $1,230.27 | Professional | RR · Rental | $758.58 | $891.25 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,570.88 | Professional | None | $2,454.71 | $2,454.71 | $4,570.88 |
4 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 $281.84 Median $309.03 Typical High $363.08 | Professional | 55 · Aftercare only | $281.84 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $204.17 Typical High $234.42 | Professional | 56 · Pre-op care only | $190.55 | $204.17 | $234.42 |
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 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,819.70 Median $2,089.30 Typical High $2,884.03 | Professional | UE · Used equipment | $1,819.70 | $2,089.30 | $2,884.03 |
Where Florida 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.
Florida· 42nd of 51
$2,754
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.