How much rates vary
Facilitymedian $4,571 · 10th to 90th $2,188 to $7,079Professionalmedian $2,692 · 10th to 90th $2,399 to $5,129
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 $2,398.83 Median $2,398.83 Typical High $4,897.79 | Professional | None | $2,398.83 | $2,398.83 | $4,897.79 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | KM · Facial prosthesis, new mold | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | KN · Facial prosthesis, prior mold | $575.44 | $575.44 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $5,128.61 Typical High $5,495.41 | Facility | None | $4,073.80 | $5,128.61 | $5,495.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $5,128.61 | Professional | None | $2,691.53 | $2,691.53 | $5,128.61 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,801.89 Median $3,801.89 Typical High $5,495.41 | Professional | KM · Facial prosthesis, new mold | $3,801.89 | $3,801.89 | $5,495.41 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,584.89 Median $1,584.89 Typical High $2,344.23 | Professional | KN · Facial prosthesis, prior mold | $1,584.89 | $1,584.89 | $2,344.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $269.15 Typical High $380.19 | Professional | RR · Rental | $269.15 | $269.15 | $380.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $2,041.74 Typical High $2,818.38 | Professional | UE · Used equipment | $2,041.74 | $2,041.74 | $2,818.38 |
CareSource Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $7,413.10 | Facility | None | $2,884.03 | $6,760.83 | $7,413.10 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $5,128.61 | Facility | None | $2,818.38 | $3,019.95 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $24,547.09 | Professional | None | $2,398.83 | $3,019.95 | $24,547.09 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,801.89 Median $4,168.69 Typical High $5,754.40 | Professional | KM · Facial prosthesis, new mold | $3,801.89 | $4,168.69 | $5,754.40 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,584.89 Median $1,778.28 Typical High $2,398.83 | Professional | KN · Facial prosthesis, prior mold | $1,584.89 | $1,778.28 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $15,488.17 | Facility | None | $912.01 | $2,089.30 | $15,488.17 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,162.28 Median $4,168.69 Typical High $6,165.95 | Professional | None | $3,162.28 | $4,168.69 | $6,165.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $3,981.07 Typical High $5,888.44 | Professional | KM · Facial prosthesis, new mold | $3,019.95 | $3,981.07 | $5,888.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,288.25 Median $1,698.24 Typical High $2,454.71 | Professional | KN · Facial prosthesis, prior mold | $1,288.25 | $1,698.24 | $2,454.71 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,511.89 Typical High $4,168.69 | Professional | None | $1,479.11 | $2,511.89 | $4,168.69 |
United Setting Professional Modifier RR · Rental Typical Low $602.56 Median $1,000.00 Typical High $1,659.59 | Professional | RR · Rental | $602.56 | $1,000.00 | $1,659.59 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,412.54 Median $2,398.83 Typical High $3,981.07 | Professional | UE · Used equipment | $1,412.54 | $2,398.83 | $3,981.07 |
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 $354.81 Median $354.81 Typical High $741.31 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $741.31 |
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 |
Where Indiana 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.
Indiana· 41st of 51
$2,692
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.