How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,380 to $3,162Professionalmedian $3,162 · 10th to 90th $1,380 to $3,890
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $1,380.38 Typical High $1,949.84 | Professional | None (both parts) | $1,380.38 | $1,380.38 | $1,949.84 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | KM · Facial prosthesis, new mold | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | KN · Facial prosthesis, prior mold | $380.19 | $380.19 | $380.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,818.38 Median $3,162.28 Typical High $3,162.28 | Facility | None | $2,818.38 | $3,162.28 | $3,162.28 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $3,162.28 Median $3,890.45 Typical High $3,890.45 | Professional | None (both parts) | $3,162.28 | $3,890.45 | $3,890.45 |
BCBS South Carolina Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | KM · Facial prosthesis, new mold | $3,019.95 | $3,019.95 | $3,019.95 |
BCBS South Carolina Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | KN · Facial prosthesis, prior mold | $1,258.93 | $1,258.93 | $1,258.93 |
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 (both parts) Typical Low $1,905.46 Median $1,905.46 Typical High $2,238.72 | Professional | None (both parts) | $1,905.46 | $1,905.46 | $2,238.72 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,778.28 Median $2,511.89 Typical High $2,511.89 | Professional | KM · Facial prosthesis, new mold | $1,778.28 | $2,511.89 | $2,511.89 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $741.31 Median $1,047.13 Typical High $1,047.13 | Professional | KN · Facial prosthesis, prior mold | $741.31 | $1,047.13 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,513.56 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,513.56 Typical High $3,801.89 | Facility | None | $954.99 | $1,513.56 | $3,801.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $2,187.76 Typical High $4,073.80 | Professional | None (both parts) | $1,737.80 | $2,187.76 | $4,073.80 |
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 (both parts) Typical Low $1,202.26 Median $1,548.82 Typical High $2,238.72 | Professional | None (both parts) | $1,202.26 | $1,548.82 | $2,238.72 |
11 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 $208.93 Median $208.93 Typical High $295.12 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $295.12 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $891.25 Median $933.25 Typical High $2,187.76 | Professional | 26 · Professional part | $891.25 | $933.25 | $2,187.76 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $3,311.31 Typical High $8,128.31 | Professional | 50 · Both sides | $2,570.40 | $3,311.31 | $8,128.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $1,096.48 Typical High $2,754.23 | Professional | 51 · Multiple procedures | $870.96 | $1,096.48 | $2,754.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $446.68 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $346.74 | $446.68 | $1,096.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $309.03 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $239.88 | $309.03 | $758.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $309.03 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $309.03 | $758.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $309.03 Typical High $758.58 | Professional | AS · PA/NP assist | $239.88 | $309.03 | $758.58 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,318.26 Median $1,380.38 Typical High $3,311.31 | Professional | TC · Technical part | $1,318.26 | $1,380.38 | $3,311.31 |
United Setting Professional Modifier RR · Rental Typical Low $478.63 Median $616.60 Typical High $891.25 | Professional | RR · Rental | $478.63 | $616.60 | $891.25 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,148.15 Median $1,479.11 Typical High $2,089.30 | Professional | UE · Used equipment | $1,148.15 | $1,479.11 | $2,089.30 |
Where South Carolina 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.
South Carolina· 6th of 51
$3,162
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.