How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,344.23 | $2,630.27 | $2,630.27 |
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 |
CareFirst Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,630.27 | $2,630.27 | $3,548.13 |
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 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $5,128.61 Typical High $7,762.47 | Professional | None | $3,630.78 | $5,128.61 | $7,762.47 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,630.78 Median $5,128.61 Typical High $7,762.47 | Professional | KM · Facial prosthesis, new mold | $3,630.78 | $5,128.61 | $7,762.47 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $3,630.78 Median $5,128.61 Typical High $7,762.47 | Professional | KN · Facial prosthesis, prior mold | $3,630.78 | $5,128.61 | $7,762.47 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $3,981.07 | Professional | None | $2,290.87 | $2,630.27 | $3,981.07 |
United Setting Professional Modifier RR · Rental Typical Low $912.01 Median $1,047.13 Typical High $1,584.89 | Professional | RR · Rental | $912.01 | $1,047.13 | $1,584.89 |
United Setting Professional Modifier UE · Used equipment Typical Low $2,137.96 Median $2,511.89 Typical High $3,715.35 | Professional | UE · Used equipment | $2,137.96 | $2,511.89 | $3,715.35 |
Wellpoint Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $4,365.16 | Professional | None | $2,691.53 | $2,691.53 | $4,365.16 |
1 more rate 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 $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $354.81 | $398.11 | $398.11 |
Where Maryland 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.
Maryland· 43rd of 51
$2,630
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.