How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,905 to $4,467Professionalmedian $3,090 · 10th to 90th $1,905 to $38,019
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 $1,905.46 Median $1,905.46 Typical High $2,089.30 | Facility | None | $1,905.46 | $1,905.46 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,905.46 | $1,905.46 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Christus Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
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 $3,090.30 Median $3,090.30 Typical High $3,630.78 | Professional | None | $3,090.30 | $3,090.30 | $3,630.78 |
Lucent Health Setting Professional Modifier None Typical Low $24,547.09 Median $38,018.94 Typical High $38,018.94 | Professional | None | $24,547.09 | $38,018.94 | $38,018.94 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,454.71 Typical High $4,466.84 | Facility | None | $1,318.26 | $2,454.71 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,905.46 | $1,949.84 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $2,884.03 Typical High $2,884.03 | Professional | None | $81.28 | $2,884.03 | $2,884.03 |
Providence Setting Facility Modifier None Typical Low $1,905.46 Median $3,630.78 Typical High $4,466.84 | Facility | None | $1,905.46 | $3,630.78 | $4,466.84 |
Providence 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 |
United Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,495.41 | Facility | None | $4,677.35 | $4,677.35 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $3,019.95 | Professional | None | $1,698.24 | $2,511.89 | $3,019.95 |
Wellpoint 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 |
18 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 $288.40 Median $288.40 Typical High $575.44 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $229.09 Typical High $549.54 | Professional | 56 · Pre-op care only | $194.98 | $229.09 | $549.54 |
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 |
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 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 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $575.44 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $575.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $213.80 Typical High $549.54 | Professional | 56 · Pre-op care only | $194.98 | $213.80 | $549.54 |
Moda Health 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 |
Moda Health 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 |
Providence 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 |
Providence 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 |
Providence 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 |
Providence 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 |
United Setting Professional Modifier RR · Rental Typical Low $676.08 Median $1,023.29 Typical High $1,230.27 | Professional | RR · Rental | $676.08 | $1,023.29 | $1,230.27 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,584.89 Median $2,398.83 Typical High $2,884.03 | Professional | UE · Used equipment | $1,584.89 | $2,398.83 | $2,884.03 |
Where Texas 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.
Texas· 25th 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.