How much rates vary
Facilitymedian $4,169 · 10th to 90th $2,399 to $23,442Professionalmedian $2,630 · 10th to 90th $1,995 to $4,365
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 $2,137.96 Median $3,162.28 Typical High $3,162.28 | Facility | None | $2,137.96 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $3,162.28 Typical High $4,365.16 | Professional | None | $2,137.96 | $3,162.28 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $21,877.62 | Facility | None | $4,677.35 | $4,677.35 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,691.53 Typical High $3,890.45 | Professional | None | $1,995.26 | $2,691.53 | $3,890.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $269.15 Typical High $2,691.53 | Professional | RR · Rental | $269.15 | $269.15 | $2,691.53 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,949.84 Median $2,041.74 Typical High $3,235.94 | Professional | UE · Used equipment | $1,949.84 | $2,041.74 | $3,235.94 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $4,677.35 | Professional | None | $2,818.38 | $2,818.38 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,019.95 | Facility | None | $2,818.38 | $2,818.38 | $3,019.95 |
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 |
Medica Setting Facility Modifier None Typical Low $2,187.76 Median $4,677.35 Typical High $23,442.29 | Facility | None | $2,187.76 | $4,677.35 | $23,442.29 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $26,302.68 | Professional | None | $1,862.09 | $2,511.89 | $26,302.68 |
Medica Setting Professional Modifier RR · Rental Typical Low $741.31 Median $933.25 Typical High $1,380.38 | Professional | RR · Rental | $741.31 | $933.25 | $1,380.38 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $2,187.76 Typical High $3,235.94 | Professional | UE · Used equipment | $1,778.28 | $2,187.76 | $3,235.94 |
United Setting Facility Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Facility | None | $6,165.95 | $6,165.95 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,290.87 | $3,467.37 |
United Setting Professional Modifier RR · Rental Typical Low $707.95 Median $933.25 Typical High $1,380.38 | Professional | RR · Rental | $707.95 | $933.25 | $1,380.38 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,659.59 Median $2,187.76 Typical High $3,311.31 | Professional | UE · Used equipment | $1,659.59 | $2,187.76 | $3,311.31 |
5 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 $316.23 Median $467.74 Typical High $660.69 | Professional | 55 · Aftercare only | $316.23 | $467.74 | $660.69 |
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 Kansas City Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,691.53 Median $2,691.53 Typical High $4,466.84 | Professional | KM · Facial prosthesis, new mold | $2,691.53 | $2,691.53 | $4,466.84 |
BCBS Kansas City Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,122.02 Median $1,122.02 Typical High $1,905.46 | Professional | KN · Facial prosthesis, prior mold | $1,122.02 | $1,122.02 | $1,905.46 |
Where Missouri 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.
Missouri· 34th 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.