How much rates vary
Facilitymedian $9,333 · 10th to 90th $2,818 to $9,333Professionalmedian $2,399 · 10th to 90th $2,089 to $5,012
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 $2,089.30 Median $2,089.30 Typical High $2,570.40 | Facility | None | $2,089.30 | $2,089.30 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,691.53 | Professional | None | $2,089.30 | $2,238.72 | $2,691.53 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,380.38 Median $1,380.38 Typical High $2,454.71 | Professional | KM · Facial prosthesis, new mold | $1,380.38 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $575.44 Median $575.44 Typical High $1,047.13 | Professional | KN · Facial prosthesis, prior mold | $575.44 | $575.44 | $1,047.13 |
Aetna Setting Professional Modifier RR · Rental Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | RR · Rental | $1,445.44 | $1,445.44 | $1,445.44 |
AvMed Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
AvMed Setting Professional Modifier None Typical Low $3,548.13 Median $4,365.16 Typical High $5,011.87 | Professional | None | $3,548.13 | $4,365.16 | $5,011.87 |
AvMed Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,801.89 Median $4,168.69 Typical High $4,786.30 | Professional | KM · Facial prosthesis, new mold | $3,801.89 | $4,168.69 | $4,786.30 |
AvMed Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,621.81 Median $1,778.28 Typical High $1,995.26 | Professional | KN · Facial prosthesis, prior mold | $1,621.81 | $1,778.28 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | KM · Facial prosthesis, new mold | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | KN · Facial prosthesis, prior mold | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,398.83 | $2,398.83 | $2,818.38 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | KM · Facial prosthesis, new mold | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | KN · Facial prosthesis, prior mold | $1,584.89 | $1,584.89 | $1,584.89 |
Florida Blue Setting Facility Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Facility | None | $9,332.54 | $9,332.54 | $9,332.54 |
Florida Blue Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Facility | KM · Facial prosthesis, new mold | $8,912.51 | $8,912.51 | $8,912.51 |
Florida Blue Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | KN · Facial prosthesis, prior mold | $3,715.35 | $3,715.35 | $3,715.35 |
Florida Blue Setting Professional Modifier None Typical Low $2,187.76 Median $5,011.87 Typical High $5,011.87 | Professional | None | $2,187.76 | $5,011.87 | $5,011.87 |
Florida Blue Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,884.03 Median $4,786.30 Typical High $4,786.30 | Professional | KM · Facial prosthesis, new mold | $2,884.03 | $4,786.30 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $3,981.07 | Professional | None | $1,621.81 | $3,801.89 | $3,981.07 |
United Setting Facility Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Facility | None | $6,165.95 | $6,165.95 | $6,165.95 |
United Setting Professional Modifier None Typical Low $60.26 Median $2,454.71 Typical High $3,388.44 | Professional | None | $60.26 | $2,454.71 | $3,388.44 |
United Setting Professional Modifier RR · Rental Typical Low $851.14 Median $977.24 Typical High $1,348.96 | Professional | RR · Rental | $851.14 | $977.24 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $5,011.87 | Professional | None | $2,691.53 | $2,691.53 | $5,011.87 |
4 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 $316.23 Median $338.84 Typical High $398.11 | Professional | 55 · Aftercare only | $316.23 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $257.04 |
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | MS · Maintenance fee | $1,445.44 | $1,445.44 | $1,445.44 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,995.26 Median $2,344.23 Typical High $3,235.94 | Professional | UE · Used equipment | $1,995.26 | $2,344.23 | $3,235.94 |
Where Florida sits
The same service costs 2.2 times more in Hawaii than in Colorado. 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.
Florida· 49th of 51
$2,455
HI $5,370CO $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.