How much rates vary
Facilitymedian $4,898 · 10th to 90th $3,631 to $5,888Professionalmedian $2,455 · 10th to 90th $2,399 to $4,169
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 $2,089.30 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,089.30 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,995.26 Median $2,570.40 Typical High $2,570.40 | Professional | KM · Facial prosthesis, new mold | $1,995.26 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | KN · Facial prosthesis, prior mold | $831.76 | $1,071.52 | $1,071.52 |
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 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $5,248.07 Typical High $6,025.60 | Facility | None | $4,466.84 | $5,248.07 | $6,025.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | KM · Facial prosthesis, new mold | $5,248.07 | $5,248.07 | $5,248.07 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | KN · Facial prosthesis, prior mold | $2,187.76 | $2,187.76 | $2,187.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | RR · Rental | $245.47 | $245.47 | $245.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | UE · Used equipment | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,890.45 | Facility | None | $3,630.78 | $3,630.78 | $3,890.45 |
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 $2,041.74 Median $4,168.69 Typical High $6,918.31 | Professional | None | $2,041.74 | $4,168.69 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier RR · Rental Typical Low $630.96 Median $954.99 Typical High $1,412.54 | Professional | RR · Rental | $630.96 | $954.99 | $1,412.54 |
Harvard Pilgrim Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $2,290.87 Typical High $3,311.31 | Professional | UE · Used equipment | $1,513.56 | $2,290.87 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,398.83 Typical High $3,890.45 | Professional | None | $1,584.89 | $2,398.83 | $3,890.45 |
United Setting Professional Modifier RR · Rental Typical Low $630.96 Median $954.99 Typical High $1,380.38 | Professional | RR · Rental | $630.96 | $954.99 | $1,380.38 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $2,290.87 Typical High $3,235.94 | Professional | UE · Used equipment | $1,513.56 | $2,290.87 | $3,235.94 |
Well Sense Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
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 $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $316.23 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $208.93 | $269.15 | $269.15 |
Where New Hampshire 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.
New Hampshire· 48th of 51
$2,455
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.