How much rates vary
Facilitymedian $3,890 · 10th to 90th $3,236 to $19,055Professionalmedian $3,090 · 10th to 90th $2,042 to $4,365
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 $2,041.74 Median $2,041.74 Typical High $2,137.96 | Facility | None | $2,041.74 | $2,041.74 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,995.26 | $2,137.96 | $2,238.72 |
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 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,715.35 | Professional | None | $3,467.37 | $3,467.37 | $3,715.35 |
Capital Blue Cross Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,467.37 Median $4,365.16 Typical High $4,365.16 | Professional | KM · Facial prosthesis, new mold | $3,467.37 | $4,365.16 | $4,365.16 |
Capital Blue Cross Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,819.70 Typical High $1,819.70 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,819.70 | $1,819.70 |
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 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 $22,387.21 | Professional | None | $3,090.30 | $3,090.30 | $22,387.21 |
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 Professional Modifier None Typical Low $4,677.35 Median $7,413.10 Typical High $8,511.38 | Professional | None | $4,677.35 | $7,413.10 | $8,511.38 |
Geisinger Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Geisinger Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $4,677.35 | Professional | None | $2,398.83 | $2,818.38 | $4,677.35 |
Geisinger Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,290.87 Median $2,630.27 Typical High $4,365.16 | Professional | KM · Facial prosthesis, new mold | $2,290.87 | $2,630.27 | $4,365.16 |
Geisinger Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $954.99 Median $1,122.02 Typical High $1,862.09 | Professional | KN · Facial prosthesis, prior mold | $954.99 | $1,122.02 | $1,862.09 |
Martin's Point Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Martin's Point Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,995.26 | $2,137.96 | $2,238.72 |
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 |
Oscar Health Setting Professional Modifier None Typical Low $4,570.88 Median $7,079.46 Typical High $7,585.78 | Professional | None | $4,570.88 | $7,079.46 | $7,585.78 |
UPMC Health Plan Setting Facility Modifier None Typical Low $3,235.94 Median $14,791.08 Typical High $25,703.96 | Facility | None | $3,235.94 | $14,791.08 | $25,703.96 |
UPMC Health Plan Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Professional | None | $3,235.94 | $3,235.94 | $4,365.16 |
UPMC Health Plan Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | KM · Facial prosthesis, new mold | $4,073.80 | $4,073.80 | $4,073.80 |
UPMC Health Plan Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | KN · Facial prosthesis, prior mold | $1,737.80 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $6,606.93 | Facility | None | $5,495.41 | $5,495.41 | $6,606.93 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $3,548.13 | Professional | None | $2,041.74 | $2,290.87 | $3,548.13 |
6 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 $302.00 Median $316.23 Typical High $338.84 | Professional | 55 · Aftercare only | $302.00 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $194.98 Typical High $281.84 | Professional | 56 · Pre-op care only | $181.97 | $194.98 | $281.84 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $4,073.80 Median $4,570.88 Typical High $4,570.88 | Professional | 50 · Both sides | $4,073.80 | $4,570.88 | $4,570.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $323.59 Typical High $338.84 | Professional | 55 · Aftercare only | $302.00 | $323.59 | $338.84 |
United Setting Professional Modifier RR · Rental Typical Low $812.83 Median $912.01 Typical High $1,380.38 | Professional | RR · Rental | $812.83 | $912.01 | $1,380.38 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,905.46 Median $2,137.96 Typical High $3,235.94 | Professional | UE · Used equipment | $1,905.46 | $2,137.96 | $3,235.94 |
Where Pennsylvania 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.
Pennsylvania· 30th 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.