How much rates vary
Facilitymedian $3,631 · 10th to 90th $2,239 to $6,026Professionalmedian $2,399 · 10th to 90th $1,288 to $17,783
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 $1,445.44 Median $1,445.44 Typical High $6,606.93 | Facility | None | $1,445.44 | $1,445.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $6,606.93 | Professional | None | $1,445.44 | $1,445.44 | $6,606.93 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,380.38 Median $1,380.38 Typical High $6,309.57 | Professional | KM · Facial prosthesis, new mold | $1,380.38 | $1,380.38 | $6,309.57 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $575.44 Median $575.44 Typical High $2,630.27 | Professional | KN · Facial prosthesis, prior mold | $575.44 | $575.44 | $2,630.27 |
Aetna Setting Professional Modifier RR · Rental Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | RR · Rental | $954.99 | $954.99 | $954.99 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3,019.95 Median $3,162.28 Typical High $6,606.93 | Facility | None | $3,019.95 | $3,162.28 | $6,606.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $17,782.79 | Professional | None | $1,288.25 | $3,388.44 | $17,782.79 |
AllWays Health Partners Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,754.23 Median $3,235.94 Typical High $3,235.94 | Professional | KM · Facial prosthesis, new mold | $2,754.23 | $3,235.94 | $3,235.94 |
AllWays Health Partners Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | KN · Facial prosthesis, prior mold | $1,148.15 | $1,348.96 | $1,348.96 |
AllWays Health Partners Setting Professional Modifier RR · Rental Typical Low $446.68 Median $660.69 Typical High $1,288.25 | Professional | RR · Rental | $446.68 | $660.69 | $1,288.25 |
AllWays Health Partners Setting Professional Modifier UE · Used equipment Typical Low $1,047.13 Median $1,584.89 Typical High $3,090.30 | Professional | UE · Used equipment | $1,047.13 | $1,584.89 | $3,090.30 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $3,715.35 Median $4,365.16 Typical High $5,754.40 | Facility | None | $3,715.35 | $4,365.16 | $5,754.40 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $2,187.76 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,187.76 | $3,090.30 | $3,090.30 |
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 $2,630.27 | Professional | None | $1,905.46 | $1,905.46 | $2,630.27 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,288.25 Median $2,884.03 Typical High $3,019.95 | Professional | None | $1,288.25 | $2,884.03 | $3,019.95 |
Harvard Pilgrim Setting Professional Modifier RR · Rental Typical Low $446.68 Median $660.69 Typical High $1,288.25 | Professional | RR · Rental | $446.68 | $660.69 | $1,288.25 |
Harvard Pilgrim Setting Professional Modifier UE · Used equipment Typical Low $1,047.13 Median $1,584.89 Typical High $3,090.30 | Professional | UE · Used equipment | $1,047.13 | $1,584.89 | $3,090.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $3,019.95 Median $3,162.28 Typical High $6,606.93 | Facility | None | $3,019.95 | $3,162.28 | $6,606.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $17,782.79 | Professional | None | $1,288.25 | $3,388.44 | $17,782.79 |
Mass General Brigham Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,754.23 Median $3,235.94 Typical High $3,235.94 | Professional | KM · Facial prosthesis, new mold | $2,754.23 | $3,235.94 | $3,235.94 |
Mass General Brigham Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | KN · Facial prosthesis, prior mold | $1,148.15 | $1,348.96 | $1,348.96 |
Mass General Brigham Setting Professional Modifier RR · Rental Typical Low $446.68 Median $660.69 Typical High $1,288.25 | Professional | RR · Rental | $446.68 | $660.69 | $1,288.25 |
Mass General Brigham Setting Professional Modifier UE · Used equipment Typical Low $1,047.13 Median $1,584.89 Typical High $3,090.30 | Professional | UE · Used equipment | $1,047.13 | $1,584.89 | $3,090.30 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $3,235.94 | Professional | None | $1,096.48 | $1,737.80 | $3,235.94 |
United Setting Professional Modifier RR · Rental Typical Low $446.68 Median $660.69 Typical High $1,288.25 | Professional | RR · Rental | $446.68 | $660.69 | $1,288.25 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,047.13 Median $1,584.89 Typical High $3,090.30 | Professional | UE · Used equipment | $1,047.13 | $1,584.89 | $3,090.30 |
Well Sense Setting Facility Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $4,365.16 | Facility | None | $2,187.76 | $3,019.95 | $4,365.16 |
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 $218.78 Median $218.78 Typical High $1,000.00 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $660.69 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $660.69 |
Where Massachusetts 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.
Massachusetts· 11th of 51
$2,818
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.