How much rates vary
Facilitymedian $5,012 · 10th to 90th $3,020 to $10,233Professionalmedian $3,090 · 10th to 90th $2,138 to $7,244
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 $1,819.70 Median $2,137.96 Typical High $3,162.28 | Facility | None | $1,819.70 | $2,137.96 | $3,162.28 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,162.28 | Professional | None | $2,137.96 | $2,137.96 | $3,162.28 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $1,230.27 Typical High $1,737.80 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $1,230.27 | $1,737.80 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $724.44 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $724.44 |
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 $5,011.87 Median $5,128.61 Typical High $10,232.93 | Facility | None | $5,011.87 | $5,128.61 | $10,232.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $8,511.38 | Professional | None | $2,454.71 | $2,454.71 | $8,511.38 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $4,265.80 Typical High $5,248.07 | Professional | KM · Facial prosthesis, new mold | $3,019.95 | $4,265.80 | $5,248.07 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,288.25 Median $1,778.28 Typical High $2,187.76 | Professional | KN · Facial prosthesis, prior mold | $1,288.25 | $1,778.28 | $2,187.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $245.47 Median $245.47 Typical High $537.03 | Professional | RR · Rental | $245.47 | $245.47 | $537.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,862.09 Median $1,862.09 Typical High $3,311.31 | Professional | UE · Used equipment | $1,862.09 | $1,862.09 | $3,311.31 |
CDPHP Setting Professional Modifier None Typical Low $1,659.59 Median $3,890.45 Typical High $4,168.69 | Professional | None | $1,659.59 | $3,890.45 | $4,168.69 |
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 Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | KN · Facial prosthesis, prior mold | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
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 |
Emblem Health Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $18,197.01 | Facility | None | $5,011.87 | $8,317.64 | $18,197.01 |
Emblem Health Setting Professional Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $8,912.51 | Professional | None | $3,311.31 | $5,370.32 | $8,912.51 |
Emblem Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,467.37 Median $5,248.07 Typical High $9,120.11 | Professional | KM · Facial prosthesis, new mold | $3,467.37 | $5,248.07 | $9,120.11 |
Emblem Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $2,238.72 Typical High $3,801.89 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $2,238.72 | $3,801.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,818.38 | $3,162.28 | $4,168.69 |
Excellus BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,691.53 Median $3,019.95 Typical High $3,890.45 | Professional | KM · Facial prosthesis, new mold | $2,691.53 | $3,019.95 | $3,890.45 |
Excellus BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,148.15 Median $1,258.93 Typical High $1,659.59 | Professional | KN · Facial prosthesis, prior mold | $1,148.15 | $1,258.93 | $1,659.59 |
MVP Health Care Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $7,413.10 | Professional | None | $3,090.30 | $3,090.30 | $7,413.10 |
MVP Health Care Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,884.03 Median $2,884.03 Typical High $7,762.47 | Professional | KM · Facial prosthesis, new mold | $2,884.03 | $2,884.03 | $7,762.47 |
MVP Health Care Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,230.27 Median $1,230.27 Typical High $3,235.94 | Professional | KN · Facial prosthesis, prior mold | $1,230.27 | $1,230.27 | $3,235.94 |
United Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,244.36 | Facility | None | $5,495.41 | $5,495.41 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $3,019.95 Typical High $3,388.44 | Professional | None | $1,659.59 | $3,019.95 | $3,388.44 |
United Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | KM · Facial prosthesis, new mold | $2,454.71 | $2,454.71 | $2,454.71 |
United Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | KN · Facial prosthesis, prior mold | $1,023.29 | $1,023.29 | $1,023.29 |
United Setting Professional Modifier RR · Rental Typical Low $660.69 Median $1,202.26 Typical High $1,348.96 | Professional | RR · Rental | $660.69 | $1,202.26 | $1,348.96 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,584.89 Median $2,884.03 Typical High $3,235.94 | Professional | UE · Used equipment | $1,584.89 | $2,884.03 | $3,235.94 |
Univera Setting Facility Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $3,019.95 | Facility | None | $2,630.27 | $3,019.95 | $3,019.95 |
Univera Setting Professional Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $4,168.69 | Professional | None | $1,698.24 | $3,162.28 | $4,168.69 |
Univera Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,621.81 Median $3,019.95 Typical High $3,890.45 | Professional | KM · Facial prosthesis, new mold | $1,621.81 | $3,019.95 | $3,890.45 |
Univera Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $676.08 Median $1,258.93 Typical High $1,659.59 | Professional | KN · Facial prosthesis, prior mold | $676.08 | $1,258.93 | $1,659.59 |
3 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 $323.59 Median $323.59 Typical High $467.74 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $213.80 |
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 |
Where New York 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 York· 31st 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.