How much rates vary
Facilitymedian $5,370 · 10th to 90th $2,818 to $6,607Professionalmedian $2,692 · 10th to 90th $2,399 to $4,677
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 $2,290.87 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,187.76 Median $2,818.38 Typical High $2,818.38 | Professional | KM · Facial prosthesis, new mold | $2,187.76 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $933.25 Median $1,202.26 Typical High $1,202.26 | Professional | KN · Facial prosthesis, prior mold | $933.25 | $1,202.26 | $1,202.26 |
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 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $5,754.40 Typical High $6,760.83 | Facility | None | $4,897.79 | $5,754.40 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | KM · Facial prosthesis, new mold | $5,754.40 | $5,754.40 | $5,754.40 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | KN · Facial prosthesis, prior mold | $2,454.71 | $2,454.71 | $2,454.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | RR · Rental | $269.15 | $269.15 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | UE · Used equipment | $2,041.74 | $2,041.74 | $2,041.74 |
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 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,238.72 Median $4,677.35 Typical High $7,585.78 | Professional | None | $2,238.72 | $4,677.35 | $7,585.78 |
Harvard Pilgrim Setting Professional Modifier RR · Rental Typical Low $707.95 Median $1,047.13 Typical High $1,548.82 | Professional | RR · Rental | $707.95 | $1,047.13 | $1,548.82 |
Harvard Pilgrim Setting Professional Modifier UE · Used equipment Typical Low $1,659.59 Median $2,511.89 Typical High $3,715.35 | Professional | UE · Used equipment | $1,659.59 | $2,511.89 | $3,715.35 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,630.27 Typical High $4,265.80 | Professional | None | $1,778.28 | $2,630.27 | $4,265.80 |
United Setting Professional Modifier RR · Rental Typical Low $707.95 Median $1,047.13 Typical High $1,513.56 | Professional | RR · Rental | $707.95 | $1,047.13 | $1,513.56 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,659.59 Median $2,511.89 Typical High $3,630.78 | Professional | UE · Used equipment | $1,659.59 | $2,511.89 | $3,630.78 |
Well Sense Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
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 $346.74 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $346.74 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $239.88 | $295.12 | $295.12 |
Where New Hampshire 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.
New Hampshire· 33rd 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.