How much rates vary
Facilitymedian $933 · 10th to 90th $933 to $1,000Professionalmedian $813 · 10th to 90th $631 to $1,380
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 Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier RR · Rental Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | RR · Rental | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | None | $794.33 | $794.33 | $933.25 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,698.24 | $1,995.26 | $1,995.26 |
United Setting Professional Modifier None Typical Low $489.78 Median $812.83 Typical High $1,122.02 | Professional | None | $489.78 | $812.83 | $1,122.02 |
United Setting Professional Modifier RR · Rental Typical Low $199.53 Median $323.59 Typical High $446.68 | Professional | RR · Rental | $199.53 | $323.59 | $446.68 |
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 $204.17 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | KM · Facial prosthesis, new mold | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | KN · Facial prosthesis, prior mold | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | MS · Maintenance fee | $478.63 | $478.63 | $478.63 |
BCBS Alabama Setting Professional Modifier 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | KM · Facial prosthesis, new mold | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Professional | KM · Facial prosthesis, new mold | $1,258.93 | $1,258.93 | $1,318.26 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $549.54 |
United Setting Professional Modifier UE · Used equipment Typical Low $467.74 Median $776.25 Typical High $1,047.13 | Professional | UE · Used equipment | $467.74 | $776.25 | $1,047.13 |
Where Alabama sits
The same service costs 2.2 times more in Hawaii than in Colorado. 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.
Alabama· 45th of 51
$851
HI $1,778CO $794
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.