How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $2,137.96 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,137.96 | $2,398.83 | $2,398.83 |
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 |
CareFirst Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,398.83 | $3,162.28 |
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 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $4,677.35 Typical High $6,918.31 | Professional | None | $3,235.94 | $4,677.35 | $6,918.31 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,235.94 Median $4,677.35 Typical High $6,918.31 | Professional | KM · Facial prosthesis, new mold | $3,235.94 | $4,677.35 | $6,918.31 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $3,235.94 Median $4,677.35 Typical High $6,918.31 | Professional | KN · Facial prosthesis, prior mold | $3,235.94 | $4,677.35 | $6,918.31 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $3,548.13 | Professional | None | $2,041.74 | $2,398.83 | $3,548.13 |
United Setting Professional Modifier RR · Rental Typical Low $812.83 Median $954.99 Typical High $1,412.54 | Professional | RR · Rental | $812.83 | $954.99 | $1,412.54 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,949.84 Median $2,290.87 Typical High $3,388.44 | Professional | UE · Used equipment | $1,949.84 | $2,290.87 | $3,388.44 |
Wellpoint Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,981.07 | Professional | None | $2,454.71 | $2,454.71 | $3,981.07 |
1 more rate 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 $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $316.23 | $354.81 | $354.81 |
Where Maryland 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.
Maryland· 44th of 51
$2,455
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.