How much rates vary
Facilitymedian $4,169 · 10th to 90th $2,138 to $6,457Professionalmedian $2,455 · 10th to 90th $2,138 to $4,677
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 $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,466.84 | Professional | None | $2,137.96 | $2,137.96 | $4,466.84 |
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 $3,630.78 Median $4,677.35 Typical High $4,897.79 | Facility | None | $3,630.78 | $4,677.35 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,677.35 | Professional | None | $2,454.71 | $2,454.71 | $4,677.35 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $5,011.87 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $5,011.87 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $2,089.30 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $2,089.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $245.47 Median $245.47 Typical High $354.81 | Professional | RR · Rental | $245.47 | $245.47 | $354.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,862.09 Median $1,862.09 Typical High $2,570.40 | Professional | UE · Used equipment | $1,862.09 | $1,862.09 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $2,570.40 Median $6,165.95 Typical High $6,606.93 | Facility | None | $2,570.40 | $6,165.95 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $3,630.78 Typical High $4,677.35 | Facility | None | $2,818.38 | $3,630.78 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $22,387.21 | Professional | None | $3,090.30 | $3,630.78 | $22,387.21 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,801.89 Typical High $5,128.61 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,801.89 | $5,128.61 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,584.89 Typical High $2,187.76 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,584.89 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $14,125.38 | Facility | None | $912.01 | $2,089.30 | $14,125.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,884.03 Median $3,801.89 Typical High $5,623.41 | Professional | None | $2,884.03 | $3,801.89 | $5,623.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,754.23 Median $3,630.78 Typical High $5,370.32 | Professional | KM · Facial prosthesis, new mold | $2,754.23 | $3,630.78 | $5,370.32 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,148.15 Median $1,513.56 Typical High $2,238.72 | Professional | KN · Facial prosthesis, prior mold | $1,148.15 | $1,513.56 | $2,238.72 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,348.96 | $2,238.72 | $3,801.89 |
United Setting Professional Modifier RR · Rental Typical Low $537.03 Median $912.01 Typical High $1,513.56 | Professional | RR · Rental | $537.03 | $912.01 | $1,513.56 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $2,137.96 Typical High $3,548.13 | Professional | UE · Used equipment | $1,288.25 | $2,137.96 | $3,548.13 |
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 $323.59 Median $323.59 Typical High $660.69 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $446.68 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $446.68 |
Where Indiana 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.
Indiana· 50th of 51
$2,455
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.