How much rates vary
Facilitymedian $5,623 · 10th to 90th $2,818 to $11,220Professionalmedian $3,311 · 10th to 90th $2,399 to $7,943
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 $2,041.74 Median $2,398.83 Typical High $3,467.37 | Facility | None | $2,041.74 | $2,398.83 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,467.37 | Professional | None | $2,398.83 | $2,398.83 | $3,467.37 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,380.38 Median $1,380.38 Typical High $1,905.46 | Professional | KM · Facial prosthesis, new mold | $1,380.38 | $1,380.38 | $1,905.46 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $575.44 Median $575.44 Typical High $812.83 | Professional | KN · Facial prosthesis, prior mold | $575.44 | $575.44 | $812.83 |
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 $5,623.41 Median $5,754.40 Typical High $11,220.18 | Facility | None | $5,623.41 | $5,754.40 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $9,549.93 | Professional | None | $2,691.53 | $2,691.53 | $9,549.93 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $4,677.35 Typical High $5,754.40 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $4,677.35 | $5,754.40 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,412.54 Median $1,995.26 Typical High $2,454.71 | Professional | KN · Facial prosthesis, prior mold | $1,412.54 | $1,995.26 | $2,454.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $269.15 Typical High $588.84 | Professional | RR · Rental | $269.15 | $269.15 | $588.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $2,041.74 Typical High $3,630.78 | Professional | UE · Used equipment | $2,041.74 | $2,041.74 | $3,630.78 |
CDPHP Setting Professional Modifier None Typical Low $1,819.70 Median $4,365.16 Typical High $4,570.88 | Professional | None | $1,819.70 | $4,365.16 | $4,570.88 |
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 Facility Modifier KM · Facial prosthesis, new mold Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | KM · Facial prosthesis, new mold | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | KN · Facial prosthesis, prior mold | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | KM · Facial prosthesis, new mold | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | KN · Facial prosthesis, prior mold | $1,584.89 | $1,584.89 | $1,584.89 |
Emblem Health Setting Facility Modifier None Typical Low $5,623.41 Median $9,332.54 Typical High $20,417.38 | Facility | None | $5,623.41 | $9,332.54 | $20,417.38 |
Emblem Health Setting Professional Modifier None Typical Low $3,630.78 Median $5,248.07 Typical High $10,000.00 | Professional | None | $3,630.78 | $5,248.07 | $10,000.00 |
Emblem Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,801.89 Median $5,011.87 Typical High $10,000.00 | Professional | KM · Facial prosthesis, new mold | $3,801.89 | $5,011.87 | $10,000.00 |
Emblem Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,621.81 Median $2,137.96 Typical High $4,265.80 | Professional | KN · Facial prosthesis, prior mold | $1,621.81 | $2,137.96 | $4,265.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $3,548.13 Typical High $4,570.88 | Professional | None | $3,162.28 | $3,548.13 | $4,570.88 |
Excellus BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $3,311.31 Typical High $4,365.16 | Professional | KM · Facial prosthesis, new mold | $3,019.95 | $3,311.31 | $4,365.16 |
Excellus BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,258.93 Median $1,412.54 Typical High $1,819.70 | Professional | KN · Facial prosthesis, prior mold | $1,258.93 | $1,412.54 | $1,819.70 |
MVP Health Care Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $8,128.31 | Professional | None | $3,388.44 | $3,388.44 | $8,128.31 |
MVP Health Care Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,235.94 Median $3,235.94 Typical High $8,511.38 | Professional | KM · Facial prosthesis, new mold | $3,235.94 | $3,235.94 | $8,511.38 |
MVP Health Care Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,348.96 Median $1,348.96 Typical High $3,630.78 | Professional | KN · Facial prosthesis, prior mold | $1,348.96 | $1,348.96 | $3,630.78 |
United Setting Facility Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $7,943.28 | Facility | None | $6,165.95 | $6,165.95 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $3,311.31 Typical High $3,715.35 | Professional | None | $1,819.70 | $3,311.31 | $3,715.35 |
United Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | KM · Facial prosthesis, new mold | $2,691.53 | $2,691.53 | $2,691.53 |
United Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | KN · Facial prosthesis, prior mold | $1,148.15 | $1,148.15 | $1,148.15 |
United Setting Professional Modifier RR · Rental Typical Low $724.44 Median $1,348.96 Typical High $1,513.56 | Professional | RR · Rental | $724.44 | $1,348.96 | $1,513.56 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,737.80 Median $3,162.28 Typical High $3,548.13 | Professional | UE · Used equipment | $1,737.80 | $3,162.28 | $3,548.13 |
Univera Setting Facility Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $3,311.31 | Facility | None | $2,951.21 | $3,311.31 | $3,311.31 |
Univera Setting Professional Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $4,570.88 | Professional | None | $1,905.46 | $3,548.13 | $4,570.88 |
Univera Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,778.28 Median $3,311.31 Typical High $4,365.16 | Professional | KM · Facial prosthesis, new mold | $1,778.28 | $3,311.31 | $4,365.16 |
Univera Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $758.58 Median $1,412.54 Typical High $1,819.70 | Professional | KN · Facial prosthesis, prior mold | $758.58 | $1,412.54 | $1,819.70 |
3 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 $363.08 Median $363.08 Typical High $524.81 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $239.88 |
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 |
Where New York 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 York· 21st of 51
$3,311
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.