How much rates vary
Facilitymedian $6,761 · 10th to 90th $3,890 to $12,589Professionalmedian $2,692 · 10th to 90th $2,399 to $4,677
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 Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,691.53 | $3,548.13 | $3,548.13 |
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 $5,248.07 Median $6,760.83 Typical High $12,589.25 | Facility | None | $5,248.07 | $6,760.83 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,691.53 | $2,691.53 | $2,951.21 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,365.16 Median $5,495.41 Typical High $7,244.36 | Professional | KM · Facial prosthesis, new mold | $4,365.16 | $5,495.41 | $7,244.36 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,819.70 Median $2,344.23 Typical High $3,090.30 | Professional | KN · Facial prosthesis, prior mold | $1,819.70 | $2,344.23 | $3,090.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | RR · Rental | $269.15 | $269.15 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $2,041.74 Typical High $2,238.72 | Professional | UE · Used equipment | $2,041.74 | $2,041.74 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $3,890.45 | Facility | None | $2,511.89 | $2,818.38 | $3,890.45 |
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 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,089.30 Median $4,677.35 Typical High $6,025.60 | Professional | None | $2,089.30 | $4,677.35 | $6,025.60 |
Harvard Pilgrim Setting Professional Modifier RR · Rental Typical Low $831.76 Median $1,047.13 Typical High $2,951.21 | Professional | RR · Rental | $831.76 | $1,047.13 | $2,951.21 |
Harvard Pilgrim Setting Professional Modifier UE · Used equipment Typical Low $1,949.84 Median $2,511.89 Typical High $6,918.31 | Professional | UE · Used equipment | $1,949.84 | $2,511.89 | $6,918.31 |
Martin's Point Setting Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,691.53 | $3,548.13 | $3,548.13 |
Martin's Point 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 |
Martin's Point 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 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $7,413.10 | Professional | None | $2,089.30 | $2,630.27 | $7,413.10 |
United Setting Professional Modifier RR · Rental Typical Low $831.76 Median $1,047.13 Typical High $2,951.21 | Professional | RR · Rental | $831.76 | $1,047.13 | $2,951.21 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,949.84 Median $2,511.89 Typical High $6,918.31 | Professional | UE · Used equipment | $1,949.84 | $2,511.89 | $6,918.31 |
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 $407.38 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $407.38 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $407.38 | $537.03 | $537.03 |
Where Maine 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.
Maine· 40th 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.