How much rates vary
Facilitymedian $7,079 · 10th to 90th $2,818 to $29,512Professionalmedian $2,692 · 10th to 90th $2,291 to $6,026
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 $2,511.89 Median $2,511.89 Typical High $5,128.61 | Facility | None | $2,511.89 | $2,511.89 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $4,073.80 | Professional | None | $2,511.89 | $2,511.89 | $4,073.80 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,380.38 Median $1,380.38 Typical High $2,187.76 | Professional | KM · Facial prosthesis, new mold | $1,380.38 | $1,380.38 | $2,187.76 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $575.44 Median $575.44 Typical High $933.25 | Professional | KN · Facial prosthesis, prior mold | $575.44 | $575.44 | $933.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $6,165.95 Median $8,511.38 Typical High $34,673.69 | Facility | None | $6,165.95 | $8,511.38 | $34,673.69 |
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 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 |
Hally Health Setting Professional Modifier None Typical Low $3,981.07 Median $5,495.41 Typical High $7,079.46 | Professional | None | $3,981.07 | $5,495.41 | $7,079.46 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,168.69 | Professional | None | $3,467.37 | $3,467.37 | $4,168.69 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $7,244.36 Typical High $7,244.36 | Facility | None | $5,128.61 | $7,244.36 | $7,244.36 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $5,888.44 | Professional | None | $2,137.96 | $2,511.89 | $5,888.44 |
United Setting Professional Modifier RR · Rental Typical Low $851.14 Median $1,000.00 Typical High $2,454.71 | Professional | RR · Rental | $851.14 | $1,000.00 | $2,454.71 |
United Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $2,398.83 Typical High $5,623.41 | Professional | UE · Used equipment | $2,041.74 | $2,398.83 | $5,623.41 |
2 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 $371.54 Median $371.54 Typical High $616.60 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $407.38 Typical High $512.86 | Professional | 56 · Pre-op care only | $234.42 | $407.38 | $512.86 |
Where Illinois 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.
Illinois· 26th of 51
$2,818
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.