How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,820 to $3,802Professionalmedian $1,738 · 10th to 90th $1,549 to $2,188
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 Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,548.82 | $1,659.59 | $1,659.59 |
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 $2,691.53 Median $3,467.37 Typical High $4,168.69 | Facility | None | $2,691.53 | $3,467.37 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,862.09 | Professional | None | $1,737.80 | $1,737.80 | $1,862.09 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,570.40 Median $3,019.95 Typical High $4,073.80 | Professional | KM · Facial prosthesis, new mold | $2,570.40 | $3,019.95 | $4,073.80 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,096.48 Median $1,288.25 Typical High $1,698.24 | Professional | KN · Facial prosthesis, prior mold | $1,096.48 | $1,288.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | RR · Rental | $173.78 | $173.78 | $173.78 |
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 $1,905.46 | Facility | None | $1,819.70 | $1,819.70 | $1,905.46 |
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 |
ConnectiCare 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 |
ConnectiCare Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $3,981.07 | Professional | None | $2,238.72 | $2,398.83 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,698.24 | $2,187.76 |
United Setting Professional Modifier RR · Rental Typical Low $524.81 Median $676.08 Typical High $870.96 | Professional | RR · Rental | $524.81 | $676.08 | $870.96 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,230.27 Median $1,621.81 Typical High $2,089.30 | Professional | UE · Used equipment | $1,230.27 | $1,621.81 | $2,089.30 |
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 $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $154.88 | $165.96 | $165.96 |
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 Connecticut 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.
Connecticut· 41st of 51
$1,738
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.