How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,259 to $6,310Professionalmedian $2,455 · 10th to 90th $2,089 to $3,890
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 $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,238.72 | $2,398.83 | $2,398.83 |
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 $4,677.35 Median $4,677.35 Typical High $4,897.79 | Facility | None | $4,677.35 | $4,677.35 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,019.95 | Professional | None | $2,454.71 | $2,454.71 | $3,019.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $245.47 Median $245.47 Typical High $323.59 | Professional | RR · Rental | $245.47 | $245.47 | $323.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,862.09 Median $1,862.09 Typical High $1,995.26 | Professional | UE · Used equipment | $1,862.09 | $1,862.09 | $1,995.26 |
CareFirst Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,398.83 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $3,630.78 Typical High $3,630.78 | Facility | None | $1,698.24 | $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 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $4,677.35 Typical High $6,025.60 | Professional | None | $3,235.94 | $4,677.35 | $6,025.60 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $3,019.95 Typical High $4,265.80 | Professional | None | $2,754.23 | $3,019.95 | $4,265.80 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $2,511.89 Typical High $3,019.95 | Facility | None | $1,445.44 | $2,511.89 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,511.89 | $2,511.89 | $3,090.30 |
Sentara Setting Facility Modifier None Typical Low $1,202.26 Median $3,019.95 Typical High $7,079.46 | Facility | None | $1,202.26 | $3,019.95 | $7,079.46 |
Sentara Setting Professional Modifier None Typical Low $1,258.93 Median $3,019.95 Typical High $6,025.60 | Professional | None | $1,258.93 | $3,019.95 | $6,025.60 |
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 $3,388.44 | Professional | None | $2,041.74 | $2,290.87 | $3,388.44 |
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 $1,949.84 Median $2,137.96 Typical High $3,235.94 | Professional | UE · Used equipment | $1,949.84 | $2,137.96 | $3,235.94 |
13 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 $338.84 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $338.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $239.88 |
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 |
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 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $3,019.95 Typical High $5,011.87 | Professional | KM · Facial prosthesis, new mold | $3,019.95 | $3,019.95 | $5,011.87 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,288.25 Median $1,288.25 Typical High $2,089.30 | Professional | KN · Facial prosthesis, prior mold | $1,288.25 | $1,288.25 | $2,089.30 |
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 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,235.94 Median $4,677.35 Typical High $6,025.60 | Professional | KM · Facial prosthesis, new mold | $3,235.94 | $4,677.35 | $6,025.60 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $3,235.94 Median $4,677.35 Typical High $6,025.60 | Professional | KN · Facial prosthesis, prior mold | $3,235.94 | $4,677.35 | $6,025.60 |
Sentara Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,511.89 Median $3,235.94 Typical High $5,754.40 | Professional | KM · Facial prosthesis, new mold | $2,511.89 | $3,235.94 | $5,754.40 |
Sentara Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,071.52 Median $1,380.38 Typical High $2,398.83 | Professional | KN · Facial prosthesis, prior mold | $1,071.52 | $1,380.38 | $2,398.83 |
Where Virginia 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.
Virginia· 46th 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.