How much rates vary
Facilitymedian $3,631 · 10th to 90th $2,291 to $6,166Professionalmedian $2,455 · 10th to 90th $2,042 to $3,631
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 $1,479.11 Median $2,290.87 Typical High $2,344.23 | Facility | None | $1,479.11 | $2,290.87 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $4,466.84 | Professional | None | $1,905.46 | $2,290.87 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,570.88 Typical High $4,786.30 | Facility | None | $2,818.38 | $4,570.88 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,019.95 | Professional | None | $2,089.30 | $2,454.71 | $3,019.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | RR · Rental | $245.47 | $245.47 | $245.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | UE · Used equipment | $1,862.09 | $1,862.09 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $3,162.28 Typical High $6,165.95 | Facility | None | $1,348.96 | $3,162.28 | $6,165.95 |
CareSource Setting Professional Modifier None Typical Low $1,949.84 Median $4,677.35 Typical High $6,760.83 | Professional | None | $1,949.84 | $4,677.35 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $6,165.95 | Facility | None | $3,630.78 | $3,630.78 | $6,165.95 |
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 |
Molina Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | None | $741.31 | $741.31 | $891.25 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,090.30 | Professional | None | $1,513.56 | $2,238.72 | $3,090.30 |
United Setting Professional Modifier RR · Rental Typical Low $588.84 Median $870.96 Typical High $1,230.27 | Professional | RR · Rental | $588.84 | $870.96 | $1,230.27 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,412.54 Median $2,089.30 Typical High $2,884.03 | Professional | UE · Used equipment | $1,412.54 | $2,089.30 | $2,884.03 |
8 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 $281.84 Median $346.74 Typical High $660.69 | Professional | 55 · Aftercare only | $281.84 | $346.74 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $229.09 Typical High $446.68 | Professional | 56 · Pre-op care only | $147.91 | $229.09 | $446.68 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $645.65 Median $1,230.27 Typical High $1,412.54 | Professional | KM · Facial prosthesis, new mold | $645.65 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $269.15 Median $524.81 Typical High $588.84 | Professional | KN · Facial prosthesis, prior mold | $269.15 | $524.81 | $588.84 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $4,265.80 Typical High $8,128.31 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $4,265.80 | $8,128.31 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,819.70 Typical High $3,388.44 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,819.70 | $3,388.44 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,311.31 Median $3,467.37 Typical High $3,630.78 | Professional | KM · Facial prosthesis, new mold | $3,311.31 | $3,467.37 | $3,630.78 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,412.54 Median $1,445.44 Typical High $1,548.82 | Professional | KN · Facial prosthesis, prior mold | $1,412.54 | $1,445.44 | $1,548.82 |
Where Kentucky 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.
Kentucky· 45th 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.