How much rates vary
Facilitymedian $8,511 · 10th to 90th $2,818 to $21,878Professionalmedian $3,631 · 10th to 90th $2,455 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 $2,884.03 Median $3,019.95 Typical High $5,011.87 | Facility | None | $2,884.03 | $3,019.95 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $5,011.87 | Professional | None | $2,884.03 | $2,884.03 | $5,011.87 |
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 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,025.60 Median $14,791.08 Typical High $28,183.83 | Facility | None | $6,025.60 | $14,791.08 | $28,183.83 |
BCBS Michigan Setting Professional Modifier None Typical Low $4,786.30 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,786.30 | $5,011.87 | $5,011.87 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $3,019.95 Typical High $3,235.94 | Facility | None | $1,288.25 | $3,019.95 | $3,235.94 |
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 $2,818.38 Typical High $5,011.87 | Professional | None | $2,398.83 | $2,818.38 | $5,011.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,884.03 Median $9,772.37 Typical High $10,715.19 | Facility | None | $2,884.03 | $9,772.37 | $10,715.19 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,570.40 Median $3,981.07 Typical High $5,128.61 | Professional | None | $2,570.40 | $3,981.07 | $5,128.61 |
Health Alliance Plan Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,380.38 Median $3,801.89 Typical High $4,897.79 | Professional | KM · Facial prosthesis, new mold | $1,380.38 | $3,801.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $575.44 Median $1,584.89 Typical High $2,041.74 | Professional | KN · Facial prosthesis, prior mold | $575.44 | $1,584.89 | $2,041.74 |
Priority Health 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 |
Priority Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $5,011.87 | Professional | None | $2,818.38 | $3,388.44 | $5,011.87 |
Priority Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,801.89 Median $3,801.89 Typical High $3,981.07 | Professional | KM · Facial prosthesis, new mold | $3,801.89 | $3,801.89 | $3,981.07 |
Priority Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,584.89 Median $1,584.89 Typical High $1,659.59 | Professional | KN · Facial prosthesis, prior mold | $1,584.89 | $1,584.89 | $1,659.59 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $6,165.95 Typical High $7,244.36 | Facility | None | $5,128.61 | $6,165.95 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,398.83 | $3,388.44 |
7 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 $426.58 Median $426.58 Typical High $758.58 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $630.96 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $630.96 |
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 |
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 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $426.58 |
United Setting Professional Modifier RR · Rental Typical Low $741.31 Median $954.99 Typical High $1,380.38 | Professional | RR · Rental | $741.31 | $954.99 | $1,380.38 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $2,290.87 Typical High $3,235.94 | Professional | UE · Used equipment | $1,778.28 | $2,290.87 | $3,235.94 |
Where Michigan 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.
Michigan· 17th of 51
$3,631
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.