How much rates vary
Facilitymedian $4,677 · 10th to 90th $3,631 to $10,000Professionalmedian $4,467 · 10th to 90th $2,239 to $6,918
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 $4,570.88 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,570.88 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $7,762.47 | Professional | None | $4,570.88 | $4,570.88 | $7,762.47 |
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 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 $5,248.07 Typical High $7,585.78 | Facility | None | $4,677.35 | $5,248.07 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $4,677.35 Typical High $5,888.44 | Professional | None | $2,454.71 | $4,677.35 | $5,888.44 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,073.80 Median $4,365.16 Typical High $5,888.44 | Professional | KM · Facial prosthesis, new mold | $4,073.80 | $4,365.16 | $5,888.44 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,737.80 Median $1,862.09 Typical High $2,511.89 | Professional | KN · Facial prosthesis, prior mold | $1,737.80 | $1,862.09 | $2,511.89 |
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 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $9,332.54 Typical High $19,498.45 | Facility | None | $3,630.78 | $9,332.54 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,890.45 Typical High $8,709.64 | Professional | None | $3,090.30 | $3,890.45 | $8,709.64 |
DeanCare Setting Facility Modifier None Typical Low $1,318.26 Median $4,570.88 Typical High $5,248.07 | Facility | None | $1,318.26 | $4,570.88 | $5,248.07 |
DeanCare Setting Professional Modifier None Typical Low $2,570.40 Median $4,570.88 Typical High $5,495.41 | Professional | None | $2,570.40 | $4,570.88 | $5,495.41 |
Medica Setting Facility Modifier None Typical Low $2,238.72 Median $4,570.88 Typical High $21,379.62 | Facility | None | $2,238.72 | $4,570.88 | $21,379.62 |
Medica Setting Professional Modifier None Typical Low $2,089.30 Median $3,019.95 Typical High $23,988.33 | Professional | None | $2,089.30 | $3,019.95 | $23,988.33 |
Medica Setting Professional Modifier RR · Rental Typical Low $831.76 Median $1,202.26 Typical High $1,548.82 | Professional | RR · Rental | $831.76 | $1,202.26 | $1,548.82 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $1,995.26 Median $2,884.03 Typical High $3,715.35 | Professional | UE · Used equipment | $1,995.26 | $2,884.03 | $3,715.35 |
Network Health Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Network Health Setting Professional Modifier None Typical Low $3,311.31 Median $4,265.80 Typical High $7,943.28 | Professional | None | $3,311.31 | $4,265.80 | $7,943.28 |
Network Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,090.30 Median $4,073.80 Typical High $7,585.78 | Professional | KM · Facial prosthesis, new mold | $3,090.30 | $4,073.80 | $7,585.78 |
Network Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,318.26 Median $1,698.24 Typical High $3,162.28 | Professional | KN · Facial prosthesis, prior mold | $1,318.26 | $1,698.24 | $3,162.28 |
Prevea360 Setting Facility Modifier None Typical Low $1,318.26 Median $4,570.88 Typical High $5,248.07 | Facility | None | $1,318.26 | $4,570.88 | $5,248.07 |
Prevea360 Setting Professional Modifier None Typical Low $2,570.40 Median $4,570.88 Typical High $4,677.35 | Professional | None | $2,570.40 | $4,570.88 | $4,677.35 |
Quartz Setting Professional Modifier None Typical Low $4,466.84 Median $6,456.54 Typical High $10,232.93 | Professional | None | $4,466.84 | $6,456.54 | $10,232.93 |
Quartz 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 |
Quartz 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 $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 $1,698.24 Median $3,019.95 Typical High $3,890.45 | Professional | None | $1,698.24 | $3,019.95 | $3,890.45 |
United Setting Professional Modifier RR · Rental Typical Low $676.08 Median $1,202.26 Typical High $1,621.81 | Professional | RR · Rental | $676.08 | $1,202.26 | $1,621.81 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,584.89 Median $2,884.03 Typical High $3,801.89 | Professional | UE · Used equipment | $1,584.89 | $2,884.03 | $3,801.89 |
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 $676.08 Median $676.08 Typical High $1,174.90 | Professional | 55 · Aftercare only | $676.08 | $676.08 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $457.09 Typical High $776.25 | Professional | 56 · Pre-op care only | $457.09 | $457.09 | $776.25 |
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 Wisconsin 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.
Wisconsin· 3rd of 51
$4,571
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.