How much rates vary
Facilitymedian $1,000 · 10th to 90th $479 to $3,090Professionalmedian $794 · 10th to 90th $708 to $2,089
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 $776.25 Median $776.25 Typical High $2,238.72 | Facility | None | $776.25 | $776.25 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $891.25 | Professional | None | $776.25 | $776.25 | $891.25 |
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 RR · Rental Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | RR · Rental | $478.63 | $478.63 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $4,570.88 | Facility | None | $1,548.82 | $1,698.24 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $2,137.96 | Professional | None | $645.65 | $912.01 | $2,137.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $912.01 Typical High $912.01 | Professional | RR · Rental | $91.20 | $912.01 | $912.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | UE · Used equipment | $676.08 | $676.08 | $676.08 |
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 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | KM · Facial prosthesis, new mold | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $524.81 |
Denver HMP Setting Facility Modifier None Typical Low $478.63 Median $933.25 Typical High $1,862.09 | Facility | None | $478.63 | $933.25 | $1,862.09 |
Denver HMP Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,122.02 | $2,089.30 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,148.15 Median $1,949.84 Typical High $2,884.03 | Professional | KM · Facial prosthesis, new mold | $1,148.15 | $1,949.84 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $478.63 Median $831.76 Typical High $1,202.26 | Professional | KN · Facial prosthesis, prior mold | $478.63 | $831.76 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,951.21 Typical High $3,388.44 | Facility | None | $1,584.89 | $2,951.21 | $3,388.44 |
Select Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,584.89 | $1,995.26 |
Select Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,071.52 Median $1,513.56 Typical High $1,905.46 | Professional | KM · Facial prosthesis, new mold | $1,071.52 | $1,513.56 | $1,905.46 |
Select Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $446.68 Median $645.65 Typical High $794.33 | Professional | KN · Facial prosthesis, prior mold | $446.68 | $645.65 | $794.33 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
United Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,148.15 | Professional | None | $676.08 | $741.31 | $1,148.15 |
United Setting Professional Modifier RR · Rental Typical Low $269.15 Median $295.12 Typical High $457.09 | Professional | RR · Rental | $269.15 | $295.12 | $457.09 |
United Setting Professional Modifier UE · Used equipment Typical Low $630.96 Median $707.95 Typical High $1,071.52 | Professional | UE · Used equipment | $630.96 | $707.95 | $1,071.52 |
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 $117.49 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
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 |
Where Colorado 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.
Colorado· 51st of 51
$794
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.