How much rates vary
Facilitymedian $7,762 · 10th to 90th $3,631 to $19,953Professionalmedian $3,631 · 10th to 90th $2,239 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 $2,570.40 Median $2,754.23 Typical High $4,570.88 | Facility | None | $2,570.40 | $2,754.23 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $4,570.88 | Professional | None | $2,570.40 | $2,570.40 | $4,570.88 |
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 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,495.41 Median $13,489.63 Typical High $25,118.86 | Facility | None | $5,495.41 | $13,489.63 | $25,118.86 |
BCBS Michigan Setting Professional Modifier None Typical Low $4,265.80 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,265.80 | $4,570.88 | $4,570.88 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $2,884.03 | Facility | None | $1,148.15 | $2,754.23 | $2,884.03 |
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 $3,019.95 Median $3,630.78 Typical High $4,570.88 | Professional | None | $3,019.95 | $3,630.78 | $4,570.88 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $8,912.51 Typical High $9,549.93 | Facility | None | $2,570.40 | $8,912.51 | $9,549.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,344.23 Median $3,630.78 Typical High $4,677.35 | Professional | None | $2,344.23 | $3,630.78 | $4,677.35 |
Health Alliance Plan Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $3,467.37 Typical High $4,365.16 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $3,467.37 | $4,365.16 |
Health Alliance Plan Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $1,445.44 Typical High $1,862.09 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $1,445.44 | $1,862.09 |
Priority Health 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 |
Priority Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,630.78 Typical High $4,570.88 | Professional | None | $3,019.95 | $3,630.78 | $4,570.88 |
Priority Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $3,548.13 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $3,548.13 |
Priority Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,513.56 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,513.56 |
United Setting Facility Modifier None Typical Low $4,677.35 Median $5,495.41 Typical High $6,606.93 | Facility | None | $4,677.35 | $5,495.41 | $6,606.93 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,698.24 | $2,187.76 | $3,090.30 |
7 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 $389.05 Median $389.05 Typical High $676.08 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $562.34 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $562.34 |
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | MS · Maintenance fee | $1,318.26 | $1,318.26 | $1,318.26 |
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 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $389.05 |
United Setting Professional Modifier RR · Rental Typical Low $676.08 Median $870.96 Typical High $1,230.27 | Professional | RR · Rental | $676.08 | $870.96 | $1,230.27 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,584.89 Median $2,041.74 Typical High $2,951.21 | Professional | UE · Used equipment | $1,584.89 | $2,041.74 | $2,951.21 |
Where Michigan 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.
Michigan· 15th of 51
$3,631
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.