How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,413 to $6,918Professionalmedian $2,692 · 10th to 90th $2,291 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 $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,454.71 | $2,630.27 | $2,630.27 |
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 $5,128.61 Median $5,128.61 Typical High $5,495.41 | Facility | None | $5,128.61 | $5,128.61 | $5,495.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,691.53 | $2,691.53 | $3,311.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | RR · Rental | $269.15 | $269.15 | $354.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $2,041.74 Typical High $2,187.76 | Professional | UE · Used equipment | $2,041.74 | $2,041.74 | $2,187.76 |
CareFirst Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,630.27 | $2,630.27 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,818.38 Typical High $2,818.38 | Facility | None | $1,862.09 | $2,818.38 | $2,818.38 |
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 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $5,128.61 Typical High $6,760.83 | Professional | None | $3,630.78 | $5,128.61 | $6,760.83 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,388.44 Typical High $4,677.35 | Professional | None | $3,019.95 | $3,388.44 | $4,677.35 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $3,388.44 | Facility | None | $1,584.89 | $2,754.23 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,754.23 | $2,754.23 | $3,388.44 |
Sentara Setting Facility Modifier None Typical Low $1,318.26 Median $3,311.31 Typical High $7,762.47 | Facility | None | $1,318.26 | $3,311.31 | $7,762.47 |
Sentara Setting Professional Modifier None Typical Low $1,412.54 Median $3,388.44 Typical High $6,606.93 | Professional | None | $1,412.54 | $3,388.44 | $6,606.93 |
United Setting Facility Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $7,244.36 | Facility | None | $6,165.95 | $6,165.95 | $7,244.36 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $3,801.89 | Professional | None | $2,290.87 | $2,511.89 | $3,801.89 |
United Setting Professional Modifier RR · Rental Typical Low $912.01 Median $1,000.00 Typical High $1,513.56 | Professional | RR · Rental | $912.01 | $1,000.00 | $1,513.56 |
United Setting Professional Modifier UE · Used equipment Typical Low $2,137.96 Median $2,398.83 Typical High $3,630.78 | Professional | UE · Used equipment | $2,137.96 | $2,398.83 | $3,630.78 |
13 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 $371.54 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $371.54 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $263.03 |
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 |
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 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,388.44 Median $3,388.44 Typical High $5,495.41 | Professional | KM · Facial prosthesis, new mold | $3,388.44 | $3,388.44 | $5,495.41 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,412.54 Median $1,412.54 Typical High $2,344.23 | Professional | KN · Facial prosthesis, prior mold | $1,412.54 | $1,412.54 | $2,344.23 |
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 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,630.78 Median $5,128.61 Typical High $6,760.83 | Professional | KM · Facial prosthesis, new mold | $3,630.78 | $5,128.61 | $6,760.83 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $3,630.78 Median $5,128.61 Typical High $6,760.83 | Professional | KN · Facial prosthesis, prior mold | $3,630.78 | $5,128.61 | $6,760.83 |
Sentara Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,818.38 Median $3,630.78 Typical High $6,309.57 | Professional | KM · Facial prosthesis, new mold | $2,818.38 | $3,630.78 | $6,309.57 |
Sentara Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,174.90 Median $1,513.56 Typical High $2,691.53 | Professional | KN · Facial prosthesis, prior mold | $1,174.90 | $1,513.56 | $2,691.53 |
Where Virginia 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.
Virginia· 32nd 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.