How much rates vary
Facilitymedian $1,820 · 10th to 90th $1,660 to $4,467Professionalmedian $1,738 · 10th to 90th $1,479 to $2,570
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 $1,047.13 Median $1,659.59 Typical High $1,698.24 | Facility | None | $1,047.13 | $1,659.59 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,348.96 | $1,659.59 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $3,388.44 | Facility | None | $1,995.26 | $3,235.94 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,737.80 | $2,137.96 |
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 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $4,365.16 | Facility | None | $954.99 | $2,290.87 | $4,365.16 |
CareSource Setting Professional Modifier None Typical Low $1,412.54 Median $3,311.31 Typical High $4,786.30 | Professional | None | $1,412.54 | $3,311.31 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $4,466.84 | Facility | None | $1,819.70 | $1,819.70 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $15,848.93 | Professional | None | $1,548.82 | $1,819.70 | $15,848.93 |
Molina Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $645.65 | Professional | None | $537.03 | $537.03 | $645.65 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,584.89 | $2,238.72 |
United Setting Professional Modifier RR · Rental Typical Low $426.58 Median $630.96 Typical High $870.96 | Professional | RR · Rental | $426.58 | $630.96 | $870.96 |
United Setting Professional Modifier UE · Used equipment Typical Low $1,000.00 Median $1,479.11 Typical High $2,089.30 | Professional | UE · Used equipment | $1,000.00 | $1,479.11 | $2,089.30 |
8 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 $204.17 Median $245.47 Typical High $467.74 | Professional | 55 · Aftercare only | $204.17 | $245.47 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $104.71 | $165.96 | $165.96 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $457.09 Median $891.25 Typical High $1,000.00 | Professional | KM · Facial prosthesis, new mold | $457.09 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $194.98 Median $371.54 Typical High $416.87 | Professional | KN · Facial prosthesis, prior mold | $194.98 | $371.54 | $416.87 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,454.71 Median $3,090.30 Typical High $5,754.40 | Professional | KM · Facial prosthesis, new mold | $2,454.71 | $3,090.30 | $5,754.40 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,023.29 Median $1,288.25 Typical High $2,398.83 | Professional | KN · Facial prosthesis, prior mold | $1,023.29 | $1,288.25 | $2,398.83 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $2,398.83 Median $2,454.71 Typical High $2,630.27 | Professional | KM · Facial prosthesis, new mold | $2,398.83 | $2,454.71 | $2,630.27 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,000.00 Median $1,047.13 Typical High $1,096.48 | Professional | KN · Facial prosthesis, prior mold | $1,000.00 | $1,047.13 | $1,096.48 |
Where Kentucky 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.
Kentucky· 40th 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.