How much rates vary
Facilitymedian $5,370 · 10th to 90th $2,239 to $22,909Professionalmedian $2,239 · 10th to 90th $1,778 to $5,623
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 $1,949.84 Median $1,949.84 Typical High $3,981.07 | Facility | None | $1,949.84 | $1,949.84 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,949.84 | $1,949.84 | $3,235.94 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,786.30 Median $6,606.93 Typical High $26,915.35 | Facility | None | $4,786.30 | $6,606.93 | $26,915.35 |
BCBS Illinois Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,311.31 | Professional | None | $3,019.95 | $3,019.95 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,905.46 | $1,905.46 | $2,238.72 |
Hally Health Setting Professional Modifier None Typical Low $3,090.30 Median $4,570.88 Typical High $8,128.31 | Professional | None | $3,090.30 | $4,570.88 | $8,128.31 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Molina 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 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $4,786.30 Typical High $4,786.30 | Facility | None | $3,981.07 | $4,786.30 | $4,786.30 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $4,570.88 | Professional | None | $1,348.96 | $1,949.84 | $4,570.88 |
United Setting Professional Modifier RR · Rental Typical Low $549.54 Median $794.33 Typical High $1,905.46 | Professional | RR · Rental | $549.54 | $794.33 | $1,905.46 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $1,862.09 Typical High $4,365.16 | Professional | UE · Used equipment | $1,288.25 | $1,862.09 | $4,365.16 |
6 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 $295.12 Median $295.12 Typical High $478.63 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $323.59 Typical High $398.11 | Professional | 56 · Pre-op care only | $147.91 | $323.59 | $398.11 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | KM · Facial prosthesis, new mold | $912.01 | $912.01 | $1,202.26 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $380.19 Median $380.19 Typical High $512.86 | Professional | KN · Facial prosthesis, prior mold | $380.19 | $380.19 | $512.86 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | KM · Facial prosthesis, new mold | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | KN · Facial prosthesis, prior mold | $1,047.13 | $1,047.13 | $1,047.13 |
Where Illinois sits
The same service costs 2.1 times more in Wisconsin than in Kentucky. 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.
Illinois· 16th of 51
$2,512
WI $3,715KY $1,778
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.