How much rates vary
Facilitymedian $4,365 · 10th to 90th $3,020 to $7,413Professionalmedian $3,890 · 10th to 90th $2,042 to $7,586
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 $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,691.53 | $2,884.03 | $2,884.03 |
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 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $3,467.37 Median $4,365.16 Typical High $4,570.88 | Facility | None | $3,467.37 | $4,365.16 | $4,570.88 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $3,890.45 Median $24,547.09 Typical High $38,018.94 | Professional | None | $3,890.45 | $24,547.09 | $38,018.94 |
Asuris Northwest Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,715.35 Typical High $4,570.88 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,715.35 | $4,570.88 |
Asuris Northwest Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,412.54 Median $1,548.82 Typical High $1,905.46 | Professional | KN · Facial prosthesis, prior mold | $1,412.54 | $1,548.82 | $1,905.46 |
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 $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Kaiser Permanente Setting Facility Modifier None Typical Low $1,949.84 Median $4,677.35 Typical High $7,413.10 | Facility | None | $1,949.84 | $4,677.35 | $7,413.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $4,677.35 Typical High $7,585.78 | Professional | None | $1,949.84 | $4,677.35 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $1,819.70 Typical High $4,570.88 | Professional | None | $60.26 | $1,819.70 | $4,570.88 |
Pacific Source Setting Facility Modifier None Typical Low $3,548.13 Median $4,265.80 Typical High $4,466.84 | Facility | None | $3,548.13 | $4,265.80 | $4,466.84 |
Premera BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $8,709.64 | Facility | None | $3,890.45 | $3,890.45 | $8,709.64 |
Premera BCBS Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,715.35 Median $3,715.35 Typical High $8,317.64 | Facility | KM · Facial prosthesis, new mold | $3,715.35 | $3,715.35 | $8,317.64 |
Premera BCBS Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,548.82 Median $1,548.82 Typical High $3,467.37 | Facility | KN · Facial prosthesis, prior mold | $1,548.82 | $1,548.82 | $3,467.37 |
Premera BCBS Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,365.16 | Professional | None | $3,715.35 | $3,715.35 | $4,365.16 |
Premera BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,548.13 Median $3,548.13 Typical High $4,168.69 | Professional | KM · Facial prosthesis, new mold | $3,548.13 | $3,548.13 | $4,168.69 |
Premera BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,479.11 Median $1,479.11 Typical High $1,949.84 | Professional | KN · Facial prosthesis, prior mold | $1,479.11 | $1,479.11 | $1,949.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,630.78 Median $3,890.45 Typical High $4,786.30 | Professional | None | $3,630.78 | $3,890.45 | $4,786.30 |
Regence BlueShield Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,467.37 Median $3,715.35 Typical High $4,570.88 | Professional | KM · Facial prosthesis, new mold | $3,467.37 | $3,715.35 | $4,570.88 |
Regence BlueShield Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,548.82 Typical High $1,905.46 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,548.82 | $1,905.46 |
United Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $3,981.07 | Professional | None | $2,041.74 | $2,041.74 | $3,981.07 |
Wellpoint Setting Professional Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $6,760.83 | Professional | None | $2,454.71 | $3,162.28 | $6,760.83 |
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 $407.38 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $407.38 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $288.40 |
Premera BCBS Setting Facility Modifier NR · New when rented Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | NR · New when rented | $3,890.45 | $3,890.45 | $3,890.45 |
Premera BCBS Setting Professional Modifier NR · New when rented Typical Low $3,715.35 Median $3,715.35 Typical High $4,365.16 | Professional | NR · New when rented | $3,715.35 | $3,715.35 | $4,365.16 |
United Setting Professional Modifier RR · Rental Typical Low $812.83 Median $812.83 Typical High $1,584.89 | Professional | RR · Rental | $812.83 | $812.83 | $1,584.89 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,905.46 Median $1,905.46 Typical High $3,801.89 | Professional | UE · Used equipment | $1,905.46 | $1,905.46 | $3,801.89 |
Where Washington 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.
Washington· 9th of 51
$3,890
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.