How much rates vary
Facilitymedian $4,365 · 10th to 90th $2,884 to $7,244Professionalmedian $3,715 · 10th to 90th $2,042 to $5,370
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 $2,884.03 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,884.03 | $3,715.35 | $3,715.35 |
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 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,235.94 Median $4,365.16 Typical High $7,244.36 | Facility | None | $3,235.94 | $4,365.16 | $7,244.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,162.28 Median $4,786.30 Typical High $5,011.87 | Professional | None | $3,162.28 | $4,786.30 | $5,011.87 |
BCBS Idaho Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $4,570.88 Typical High $4,786.30 | Professional | KM · Facial prosthesis, new mold | $3,019.95 | $4,570.88 | $4,786.30 |
BCBS Idaho Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,288.25 Median $1,905.46 Typical High $1,995.26 | Professional | KN · Facial prosthesis, prior mold | $1,288.25 | $1,905.46 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,801.89 | Facility | None | $3,630.78 | $3,630.78 | $3,801.89 |
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 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $3,715.35 Typical High $4,570.88 | Facility | None | $1,318.26 | $3,715.35 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,890.45 Typical High $4,786.30 | Professional | None | $2,884.03 | $3,890.45 | $4,786.30 |
Moda Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $4,073.80 Typical High $4,570.88 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $4,073.80 | $4,570.88 |
Moda Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $1,737.80 Typical High $1,905.46 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $1,737.80 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $3,311.31 Typical High $3,890.45 | Professional | None | $30.20 | $3,311.31 | $3,890.45 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,630.78 Median $5,370.32 Typical High $275,422.87 | Facility | None | $3,630.78 | $5,370.32 | $275,422.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,570.88 Median $5,370.32 Typical High $323,593.66 | Professional | None | $4,570.88 | $5,370.32 | $323,593.66 |
MountainHealth Co-op Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,235.94 Median $4,570.88 Typical High $4,570.88 | Professional | KM · Facial prosthesis, new mold | $3,235.94 | $4,570.88 | $4,570.88 |
MountainHealth Co-op Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,380.38 Median $1,905.46 Typical High $1,905.46 | Professional | KN · Facial prosthesis, prior mold | $1,380.38 | $1,905.46 | $1,905.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,265.80 Median $4,365.16 Typical High $6,606.93 | Facility | None | $4,265.80 | $4,365.16 | $6,606.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $4,786.30 | Professional | None | $3,162.28 | $3,162.28 | $4,786.30 |
Regence BlueShield Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $3,019.95 Typical High $4,570.88 | Professional | KM · Facial prosthesis, new mold | $3,019.95 | $3,019.95 | $4,570.88 |
Regence BlueShield Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,288.25 Median $1,288.25 Typical High $1,905.46 | Professional | KN · Facial prosthesis, prior mold | $1,288.25 | $1,288.25 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $4,365.16 Median $4,570.88 Typical High $5,888.44 | Facility | None | $4,365.16 | $4,570.88 | $5,888.44 |
Select Health Setting Professional Modifier None Typical Low $2,951.21 Median $4,570.88 Typical High $5,011.87 | Professional | None | $2,951.21 | $4,570.88 | $5,011.87 |
Select Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,818.38 Median $4,365.16 Typical High $4,786.30 | Professional | KM · Facial prosthesis, new mold | $2,818.38 | $4,365.16 | $4,786.30 |
Select Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,174.90 Median $1,819.70 Typical High $1,995.26 | Professional | KN · Facial prosthesis, prior mold | $1,174.90 | $1,819.70 | $1,995.26 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,862.09 | $2,041.74 | $3,090.30 |
5 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 $436.52 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $436.52 | $562.34 | $562.34 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $3,388.44 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,951.21 | $3,388.44 | $3,548.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $436.52 | $562.34 | $562.34 |
United Setting Professional Modifier RR · Rental Typical Low $741.31 Median $812.83 Typical High $1,258.93 | Professional | RR · Rental | $741.31 | $812.83 | $1,258.93 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $1,905.46 Typical High $2,951.21 | Professional | UE · Used equipment | $1,778.28 | $1,905.46 | $2,951.21 |
Where Idaho 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.
Idaho· 10th of 51
$3,802
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.