How much rates vary
Facilitymedian $6,026 · 10th to 90th $3,631 to $11,482Professionalmedian $2,754 · 10th to 90th $2,239 to $4,169
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 Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,454.71 | $3,235.94 | $3,235.94 |
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 $4,677.35 Median $6,025.60 Typical High $11,481.54 | Facility | None | $4,677.35 | $6,025.60 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,754.23 | Professional | None | $2,454.71 | $2,454.71 | $2,754.23 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,890.45 Median $5,011.87 Typical High $6,606.93 | Professional | KM · Facial prosthesis, new mold | $3,890.45 | $5,011.87 | $6,606.93 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,659.59 Median $2,089.30 Typical High $2,754.23 | Professional | KN · Facial prosthesis, prior mold | $1,659.59 | $2,089.30 | $2,754.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $245.47 Median $245.47 Typical High $275.42 | Professional | RR · Rental | $245.47 | $245.47 | $275.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,862.09 Median $1,862.09 Typical High $2,041.74 | Professional | UE · Used equipment | $1,862.09 | $1,862.09 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $3,630.78 | Facility | None | $2,290.87 | $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 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,862.09 Median $4,168.69 Typical High $5,495.41 | Professional | None | $1,862.09 | $4,168.69 | $5,495.41 |
Harvard Pilgrim Setting Professional Modifier RR · Rental Typical Low $741.31 Median $954.99 Typical High $2,630.27 | Professional | RR · Rental | $741.31 | $954.99 | $2,630.27 |
Harvard Pilgrim Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $2,290.87 Typical High $6,309.57 | Professional | UE · Used equipment | $1,778.28 | $2,290.87 | $6,309.57 |
Martin's Point Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,454.71 | $3,235.94 | $3,235.94 |
Martin's Point 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 |
Martin's Point 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 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $6,606.93 | Professional | None | $1,862.09 | $2,398.83 | $6,606.93 |
United Setting Professional Modifier RR · Rental Typical Low $741.31 Median $954.99 Typical High $2,630.27 | Professional | RR · Rental | $741.31 | $954.99 | $2,630.27 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $2,290.87 Typical High $6,309.57 | Professional | UE · Used equipment | $1,778.28 | $2,290.87 | $6,309.57 |
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 $363.08 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $363.08 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $363.08 | $478.63 | $478.63 |
Where Maine 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.
Maine· 29th 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.