How much rates vary
Facilitymedian $6,310 · 10th to 90th $3,631 to $26,915Professionalmedian $2,884 · 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 Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $4,677.35 | Facility | None | $2,238.72 | $2,238.72 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,715.35 | Professional | None | $2,238.72 | $2,238.72 | $3,715.35 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $1,230.27 Typical High $1,995.26 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $1,230.27 | $1,995.26 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $831.76 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $831.76 |
BCBS Illinois Setting Facility Modifier None Typical Low $5,495.41 Median $7,585.78 Typical High $31,622.78 | Facility | None | $5,495.41 | $7,585.78 | $31,622.78 |
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 |
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 |
Hally Health Setting Professional Modifier None Typical Low $3,630.78 Median $4,897.79 Typical High $6,309.57 | Professional | None | $3,630.78 | $4,897.79 | $6,309.57 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,801.89 | Professional | None | $3,090.30 | $3,090.30 | $3,801.89 |
United Setting Facility Modifier None Typical Low $4,677.35 Median $6,606.93 Typical High $6,606.93 | Facility | None | $4,677.35 | $6,606.93 | $6,606.93 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $5,370.32 | Professional | None | $1,949.84 | $2,238.72 | $5,370.32 |
United Setting Professional Modifier RR · Rental Typical Low $776.25 Median $912.01 Typical High $2,187.76 | Professional | RR · Rental | $776.25 | $912.01 | $2,187.76 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,819.70 Median $2,137.96 Typical High $5,011.87 | Professional | UE · Used equipment | $1,819.70 | $2,137.96 | $5,011.87 |
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 $338.84 Median $338.84 Typical High $549.54 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $371.54 Typical High $467.74 | Professional | 56 · Pre-op care only | $204.17 | $371.54 | $467.74 |
Where Illinois 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.
Illinois· 33rd of 51
$3,090
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.