How much rates vary
Facilitymedian $1,862 · 10th to 90th $933 to $6,026Professionalmedian $1,549 · 10th to 90th $1,380 to $4,074
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,513.56 | $1,737.80 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | KM · Facial prosthesis, new mold | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | KN · Facial prosthesis, prior mold | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier RR · Rental Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | RR · Rental | $933.25 | $933.25 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $3,311.31 Typical High $8,912.51 | Facility | None | $3,019.95 | $3,311.31 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $4,168.69 | Professional | None | $1,258.93 | $1,737.80 | $4,168.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $173.78 Median $1,737.80 Typical High $1,737.80 | Professional | RR · Rental | $173.78 | $1,737.80 | $1,737.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | UE · Used equipment | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,548.82 | $1,819.70 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | KM · Facial prosthesis, new mold | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | KN · Facial prosthesis, prior mold | $1,023.29 | $1,023.29 | $1,023.29 |
Denver HMP Setting Facility Modifier None Typical Low $933.25 Median $1,819.70 Typical High $3,630.78 | Facility | None | $933.25 | $1,819.70 | $3,630.78 |
Denver HMP Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $4,073.80 Typical High $5,888.44 | Professional | None | $2,187.76 | $4,073.80 | $5,888.44 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,238.72 Median $3,890.45 Typical High $5,623.41 | Professional | KM · Facial prosthesis, new mold | $2,238.72 | $3,890.45 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $933.25 Median $1,621.81 Typical High $2,344.23 | Professional | KN · Facial prosthesis, prior mold | $933.25 | $1,621.81 | $2,344.23 |
Select Health Setting Facility Modifier None Typical Low $3,090.30 Median $5,754.40 Typical High $6,606.93 | Facility | None | $3,090.30 | $5,754.40 | $6,606.93 |
Select Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,090.30 Typical High $3,890.45 | Professional | None | $2,187.76 | $3,090.30 | $3,890.45 |
Select Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,089.30 Median $2,951.21 Typical High $3,715.35 | Professional | KM · Facial prosthesis, new mold | $2,089.30 | $2,951.21 | $3,715.35 |
Select Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $870.96 Median $1,258.93 Typical High $1,548.82 | Professional | KN · Facial prosthesis, prior mold | $870.96 | $1,258.93 | $1,548.82 |
United Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,445.44 | $2,238.72 |
United Setting Professional Modifier RR · Rental Typical Low $524.81 Median $575.44 Typical High $891.25 | Professional | RR · Rental | $524.81 | $575.44 | $891.25 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,230.27 Median $1,380.38 Typical High $2,137.96 | Professional | UE · Used equipment | $1,230.27 | $1,380.38 | $2,137.96 |
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 $229.09 Median $229.09 Typical High $263.03 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | MS · Maintenance fee | $933.25 | $933.25 | $933.25 |
Where Colorado sits
The same service costs 2.2 times more in Hawaii than in Delaware. 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.
Colorado· 50th of 51
$1,549
HI $3,467DE $1,549
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.