How much rates vary
Facilitymedian $5,129 · 10th to 90th $2,818 to $11,220Professionalmedian $4,898 · 10th to 90th $2,399 to $7,762
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 $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $8,511.38 | Professional | None | $5,011.87 | $5,011.87 | $8,511.38 |
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 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 $5,888.44 Typical High $8,511.38 | Facility | None | $5,128.61 | $5,888.44 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $5,128.61 Typical High $6,456.54 | Professional | None | $2,691.53 | $5,128.61 | $6,456.54 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $4,570.88 Median $4,897.79 Typical High $6,606.93 | Professional | KM · Facial prosthesis, new mold | $4,570.88 | $4,897.79 | $6,606.93 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,905.46 Median $2,041.74 Typical High $2,754.23 | Professional | KN · Facial prosthesis, prior mold | $1,905.46 | $2,041.74 | $2,754.23 |
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 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $10,471.29 Typical High $21,379.62 | Facility | None | $2,818.38 | $10,471.29 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $9,772.37 | Professional | None | $2,398.83 | $3,019.95 | $9,772.37 |
DeanCare Setting Facility Modifier None Typical Low $1,445.44 Median $5,011.87 Typical High $5,754.40 | Facility | None | $1,445.44 | $5,011.87 | $5,754.40 |
DeanCare Setting Professional Modifier None Typical Low $2,884.03 Median $5,011.87 Typical High $6,165.95 | Professional | None | $2,884.03 | $5,011.87 | $6,165.95 |
Medica Setting Facility Modifier None Typical Low $2,511.89 Median $5,011.87 Typical High $23,442.29 | Facility | None | $2,511.89 | $5,011.87 | $23,442.29 |
Medica Setting Professional Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $26,302.68 | Professional | None | $2,344.23 | $3,388.44 | $26,302.68 |
Medica Setting Professional Modifier RR · Rental Typical Low $933.25 Median $1,348.96 Typical High $1,737.80 | Professional | RR · Rental | $933.25 | $1,348.96 | $1,737.80 |
Medica Setting Professional Modifier UE · Used equipment Typical Low $2,187.76 Median $3,162.28 Typical High $4,073.80 | Professional | UE · Used equipment | $2,187.76 | $3,162.28 | $4,073.80 |
Network Health Setting Professional Modifier None Typical Low $3,630.78 Median $4,677.35 Typical High $8,709.64 | Professional | None | $3,630.78 | $4,677.35 | $8,709.64 |
Network Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,467.37 Median $4,466.84 Typical High $8,317.64 | Professional | KM · Facial prosthesis, new mold | $3,467.37 | $4,466.84 | $8,317.64 |
Network Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,445.44 Median $1,905.46 Typical High $3,548.13 | Professional | KN · Facial prosthesis, prior mold | $1,445.44 | $1,905.46 | $3,548.13 |
Prevea360 Setting Facility Modifier None Typical Low $1,445.44 Median $5,011.87 Typical High $5,754.40 | Facility | None | $1,445.44 | $5,011.87 | $5,754.40 |
Prevea360 Setting Professional Modifier None Typical Low $2,884.03 Median $5,011.87 Typical High $5,128.61 | Professional | None | $2,884.03 | $5,011.87 | $5,128.61 |
Quartz Setting Professional Modifier None Typical Low $5,011.87 Median $7,079.46 Typical High $11,481.54 | Professional | None | $5,011.87 | $7,079.46 | $11,481.54 |
Quartz 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 |
Quartz 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 |
United Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $3,311.31 Typical High $4,265.80 | Professional | None | $1,862.09 | $3,311.31 | $4,265.80 |
United Setting Professional Modifier RR · Rental Typical Low $741.31 Median $1,348.96 Typical High $1,778.28 | Professional | RR · Rental | $741.31 | $1,348.96 | $1,778.28 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $3,162.28 Typical High $4,265.80 | Professional | UE · Used equipment | $1,778.28 | $3,162.28 | $4,265.80 |
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 $758.58 Median $758.58 Typical High $1,288.25 | Professional | 55 · Aftercare only | $758.58 | $758.58 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $501.19 Typical High $851.14 | Professional | 56 · Pre-op care only | $501.19 | $501.19 | $851.14 |
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 Wisconsin 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.
Wisconsin· 4th of 51
$5,012
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.