How much rates vary
Facilitymedian $5,129 · 10th to 90th $3,631 to $8,318Professionalmedian $3,631 · 10th to 90th $1,862 to $24,547
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 $2,089.30 Median $2,089.30 Typical High $9,549.93 | Facility | None | $2,089.30 | $2,089.30 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $9,549.93 | Professional | None | $2,089.30 | $2,089.30 | $9,549.93 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,995.26 Median $1,995.26 Typical High $9,120.11 | Professional | KM · Facial prosthesis, new mold | $1,995.26 | $1,995.26 | $9,120.11 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $831.76 Median $831.76 Typical High $3,801.89 | Professional | KN · Facial prosthesis, prior mold | $831.76 | $831.76 | $3,801.89 |
Aetna Setting Professional Modifier RR · Rental Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | RR · Rental | $1,318.26 | $1,318.26 | $1,318.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $4,168.69 Median $4,570.88 Typical High $9,549.93 | Facility | None | $4,168.69 | $4,570.88 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,862.09 Median $4,897.79 Typical High $24,547.09 | Professional | None | $1,862.09 | $4,897.79 | $24,547.09 |
AllWays Health Partners Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,890.45 Median $4,677.35 Typical High $4,677.35 | Professional | KM · Facial prosthesis, new mold | $3,890.45 | $4,677.35 | $4,677.35 |
AllWays Health Partners Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,659.59 Median $1,949.84 Typical High $1,949.84 | Professional | KN · Facial prosthesis, prior mold | $1,659.59 | $1,949.84 | $1,949.84 |
AllWays Health Partners Setting Professional Modifier RR · Rental Typical Low $630.96 Median $954.99 Typical High $1,862.09 | Professional | RR · Rental | $630.96 | $954.99 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $2,290.87 Typical High $4,466.84 | Professional | UE · Used equipment | $1,513.56 | $2,290.87 | $4,466.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $5,370.32 Median $6,165.95 Typical High $8,317.64 | Facility | None | $5,370.32 | $6,165.95 | $8,317.64 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $3,162.28 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,162.28 | $4,365.16 | $4,365.16 |
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 $5,248.07 | Professional | None | $3,090.30 | $3,090.30 | $5,248.07 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,862.09 Median $4,168.69 Typical High $4,365.16 | Professional | None | $1,862.09 | $4,168.69 | $4,365.16 |
Harvard Pilgrim Setting Professional Modifier RR · Rental Typical Low $630.96 Median $954.99 Typical High $1,862.09 | Professional | RR · Rental | $630.96 | $954.99 | $1,862.09 |
Harvard Pilgrim Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $2,290.87 Typical High $4,466.84 | Professional | UE · Used equipment | $1,513.56 | $2,290.87 | $4,466.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $4,168.69 Median $4,570.88 Typical High $9,549.93 | Facility | None | $4,168.69 | $4,570.88 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,862.09 Median $4,897.79 Typical High $24,547.09 | Professional | None | $1,862.09 | $4,897.79 | $24,547.09 |
Mass General Brigham Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,890.45 Median $4,677.35 Typical High $4,677.35 | Professional | KM · Facial prosthesis, new mold | $3,890.45 | $4,677.35 | $4,677.35 |
Mass General Brigham Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,659.59 Median $1,949.84 Typical High $1,949.84 | Professional | KN · Facial prosthesis, prior mold | $1,659.59 | $1,949.84 | $1,949.84 |
Mass General Brigham Setting Professional Modifier RR · Rental Typical Low $630.96 Median $954.99 Typical High $1,862.09 | Professional | RR · Rental | $630.96 | $954.99 | $1,862.09 |
Mass General Brigham Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $2,290.87 Typical High $4,466.84 | Professional | UE · Used equipment | $1,513.56 | $2,290.87 | $4,466.84 |
United Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,398.83 Typical High $4,677.35 | Professional | None | $1,584.89 | $2,398.83 | $4,677.35 |
United Setting Professional Modifier RR · Rental Typical Low $630.96 Median $954.99 Typical High $1,862.09 | Professional | RR · Rental | $630.96 | $954.99 | $1,862.09 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $2,290.87 Typical High $4,466.84 | Professional | UE · Used equipment | $1,513.56 | $2,290.87 | $4,466.84 |
Well Sense Setting Facility Modifier None Typical Low $3,162.28 Median $4,365.16 Typical High $6,165.95 | Facility | None | $3,162.28 | $4,365.16 | $6,165.95 |
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 $316.23 Median $316.23 Typical High $1,445.44 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $1,445.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $954.99 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $954.99 |
Where Massachusetts 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.
Massachusetts· 8th of 51
$3,981
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.