How much rates vary
Facilitymedian $4,571 · 10th to 90th $3,631 to $16,596Professionalmedian $3,715 · 10th to 90th $2,239 to $10,715
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 Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,951.21 | Facility | None | $1,862.09 | $1,862.09 | $2,951.21 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,862.09 | $1,995.26 | $2,818.38 |
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 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $15,848.93 Typical High $16,595.87 | Facility | None | $4,570.88 | $15,848.93 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $3,981.07 Typical High $25,118.86 | Professional | None | $2,454.71 | $3,981.07 | $25,118.86 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,466.84 Median $5,248.07 Typical High $23,988.33 | Professional | KM · Facial prosthesis, new mold | $4,466.84 | $5,248.07 | $23,988.33 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,862.09 Median $2,187.76 Typical High $10,000.00 | Professional | KN · Facial prosthesis, prior mold | $1,862.09 | $2,187.76 | $10,000.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $245.47 Median $549.54 Typical High $2,511.89 | Professional | RR · Rental | $245.47 | $549.54 | $2,511.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,862.09 Median $4,168.69 Typical High $19,054.61 | Professional | UE · Used equipment | $1,862.09 | $4,168.69 | $19,054.61 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $3,630.78 Typical High $3,801.89 | Facility | None | $1,513.56 | $3,630.78 | $3,801.89 |
CareSource Setting Professional Modifier None Typical Low $1,513.56 Median $3,630.78 Typical High $3,801.89 | Professional | None | $1,513.56 | $3,630.78 | $3,801.89 |
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 $6,025.60 | Professional | None | $3,090.30 | $3,090.30 | $6,025.60 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $5,754.40 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $5,754.40 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $2,454.71 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,162.28 Median $4,570.88 Typical High $7,585.78 | Professional | None | $3,162.28 | $4,570.88 | $7,585.78 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $4,265.80 Typical High $5,128.61 | Professional | KM · Facial prosthesis, new mold | $3,019.95 | $4,265.80 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,258.93 Median $1,819.70 Typical High $2,187.76 | Professional | KN · Facial prosthesis, prior mold | $1,258.93 | $1,819.70 | $2,187.76 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,238.72 Typical High $5,754.40 | Professional | None | $1,584.89 | $2,238.72 | $5,754.40 |
United Setting Professional Modifier RR · Rental Typical Low $630.96 Median $891.25 Typical High $2,290.87 | Professional | RR · Rental | $630.96 | $891.25 | $2,290.87 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $2,089.30 Typical High $5,370.32 | Professional | UE · Used equipment | $1,513.56 | $2,089.30 | $5,370.32 |
2 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 $275.42 Median $302.00 Typical High $426.58 | Professional | 55 · Aftercare only | $275.42 | $302.00 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $263.03 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $263.03 |
Where Georgia 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.
Georgia· 13th of 51
$3,715
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.