How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,630.78 | $3,801.89 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | KM · Facial prosthesis, new mold | $5,011.87 | $5,011.87 | $5,011.87 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | KN · Facial prosthesis, prior mold | $2,137.96 | $2,137.96 | $2,137.96 |
HMSA Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $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 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $4,897.79 Typical High $6,309.57 | Professional | None | $3,235.94 | $4,897.79 | $6,309.57 |
United Setting Professional Modifier None Typical Low $3,311.31 Median $5,248.07 Typical High $5,248.07 | Professional | None | $3,311.31 | $5,248.07 | $5,248.07 |
United Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,630.78 Median $5,011.87 Typical High $5,011.87 | Professional | KM · Facial prosthesis, new mold | $3,630.78 | $5,011.87 | $5,011.87 |
United Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,513.56 Median $2,137.96 Typical High $2,137.96 | Professional | KN · Facial prosthesis, prior mold | $1,513.56 | $2,137.96 | $2,137.96 |
University Health Alliance Setting Professional Modifier None Typical Low $3,890.45 Median $3,981.07 Typical High $4,570.88 | Professional | None | $3,890.45 | $3,981.07 | $4,570.88 |
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 |
|---|---|---|---|---|---|
United Setting Professional Modifier RR · Rental Typical Low $831.76 Median $831.76 Typical High $1,318.26 | Professional | RR · Rental | $831.76 | $831.76 | $1,318.26 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,995.26 Median $1,995.26 Typical High $3,090.30 | Professional | UE · Used equipment | $1,995.26 | $1,995.26 | $3,090.30 |
Where Hawaii 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.
Hawaii· 1st of 51
$4,898
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.