How much rates vary
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 $1,445.44 Median $4,168.69 Typical High $4,265.80 | Professional | None | $1,445.44 | $4,168.69 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $4,365.16 Median $5,011.87 Typical High $5,011.87 | Facility | None | $4,365.16 | $5,011.87 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,073.80 | $5,011.87 | $5,011.87 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | KM · Facial prosthesis, new mold | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | KN · Facial prosthesis, prior mold | $1,995.26 | $1,995.26 | $1,995.26 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,630.78 Median $5,754.40 Typical High $281,838.29 | Facility | None | $3,630.78 | $5,754.40 | $281,838.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,570.88 Median $5,370.32 Typical High $295,120.92 | Professional | None | $4,570.88 | $5,370.32 | $295,120.92 |
Providence Setting Facility Modifier None Typical Low $2,691.53 Median $5,011.87 Typical High $5,011.87 | Facility | None | $2,691.53 | $5,011.87 | $5,011.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,715.35 Typical High $5,011.87 | Professional | None | $79.43 | $3,715.35 | $5,011.87 |
Providence Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,466.84 Median $4,677.35 Typical High $4,677.35 | Professional | KM · Facial prosthesis, new mold | $4,466.84 | $4,677.35 | $4,677.35 |
Providence Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,862.09 Median $1,995.26 Typical High $1,995.26 | Professional | KN · Facial prosthesis, prior mold | $1,862.09 | $1,995.26 | $1,995.26 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $3,715.35 | Professional | None | $2,137.96 | $2,238.72 | $3,715.35 |
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 |
|---|---|---|---|---|---|
United Setting Professional Modifier RR · Rental Typical Low $851.14 Median $891.25 Typical High $1,479.11 | Professional | RR · Rental | $851.14 | $891.25 | $1,479.11 |
United Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $2,137.96 Typical High $3,548.13 | Professional | UE · Used equipment | $2,041.74 | $2,137.96 | $3,548.13 |
Where Montana 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.
Montana· 3rd of 51
$5,012
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.