How much rates vary
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 $1,318.26 Median $3,715.35 Typical High $3,890.45 | Professional | None | $1,318.26 | $3,715.35 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $3,981.07 Median $4,466.84 Typical High $4,466.84 | Facility | None | $3,981.07 | $4,466.84 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $4,466.84 Typical High $4,466.84 | Professional | None | $3,890.45 | $4,466.84 | $4,466.84 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | KM · Facial prosthesis, new mold | $4,265.80 | $4,265.80 | $4,265.80 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | KN · Facial prosthesis, prior mold | $1,778.28 | $1,778.28 | $1,778.28 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,311.31 Median $5,495.41 Typical High $257,039.58 | Facility | None | $3,311.31 | $5,495.41 | $257,039.58 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,365.16 Median $4,786.30 Typical High $263,026.80 | Professional | None | $4,365.16 | $4,786.30 | $263,026.80 |
Providence Setting Facility Modifier None Typical Low $2,454.71 Median $4,466.84 Typical High $4,466.84 | Facility | None | $2,454.71 | $4,466.84 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,388.44 Typical High $4,466.84 | Professional | None | $79.43 | $3,388.44 | $4,466.84 |
Providence Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,073.80 Median $4,265.80 Typical High $4,265.80 | Professional | KM · Facial prosthesis, new mold | $4,073.80 | $4,265.80 | $4,265.80 |
Providence Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,698.24 Median $1,778.28 Typical High $1,778.28 | Professional | KN · Facial prosthesis, prior mold | $1,698.24 | $1,778.28 | $1,778.28 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $3,388.44 | Professional | None | $1,905.46 | $2,041.74 | $3,388.44 |
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 |
|---|---|---|---|---|---|
United Setting Professional Modifier RR · Rental Typical Low $776.25 Median $812.83 Typical High $1,348.96 | Professional | RR · Rental | $776.25 | $812.83 | $1,348.96 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,819.70 Median $1,905.46 Typical High $3,235.94 | Professional | UE · Used equipment | $1,819.70 | $1,905.46 | $3,235.94 |
Where Montana 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.
Montana· 4th of 51
$4,467
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.