How much rates vary
Facilitymedian $1,660 · 10th to 90th $933 to $6,166Professionalmedian $1,349 · 10th to 90th $794 to $3,890
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 $676.08 Median $676.08 Typical High $1,096.48 | Facility | None | $676.08 | $676.08 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,023.29 | Professional | None | $676.08 | $724.44 | $1,023.29 |
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 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $5,754.40 Typical High $6,165.95 | Facility | None | $1,659.59 | $5,754.40 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $9,120.11 | Professional | None | $912.01 | $1,445.44 | $9,120.11 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,621.81 Median $1,905.46 Typical High $8,709.64 | Professional | KM · Facial prosthesis, new mold | $1,621.81 | $1,905.46 | $8,709.64 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $691.83 Median $812.83 Typical High $3,715.35 | Professional | KN · Facial prosthesis, prior mold | $691.83 | $812.83 | $3,715.35 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $199.53 Typical High $912.01 | Professional | RR · Rental | $91.20 | $199.53 | $912.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $676.08 Median $1,513.56 Typical High $6,918.31 | Professional | UE · Used equipment | $676.08 | $1,513.56 | $6,918.31 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $1,380.38 | Facility | None | $549.54 | $1,318.26 | $1,380.38 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $1,318.26 Typical High $1,380.38 | Professional | None | $549.54 | $1,318.26 | $1,380.38 |
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 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 None Typical Low $794.33 Median $794.33 Typical High $2,238.72 | Professional | None | $794.33 | $794.33 | $2,238.72 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,258.93 Typical High $2,137.96 | Professional | KM · Facial prosthesis, new mold | $1,258.93 | $1,258.93 | $2,137.96 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $891.25 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,659.59 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,096.48 Median $1,584.89 Typical High $1,905.46 | Professional | KM · Facial prosthesis, new mold | $1,096.48 | $1,584.89 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $467.74 Median $660.69 Typical High $794.33 | Professional | KN · Facial prosthesis, prior mold | $467.74 | $660.69 | $794.33 |
United Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $2,089.30 | Professional | None | $575.44 | $812.83 | $2,089.30 |
United Setting Professional Modifier RR · Rental Typical Low $234.42 Median $323.59 Typical High $831.76 | Professional | RR · Rental | $234.42 | $323.59 | $831.76 |
United Setting Professional Modifier UE · Used equipment Typical Low $549.54 Median $776.25 Typical High $1,995.26 | Professional | UE · Used equipment | $549.54 | $776.25 | $1,995.26 |
2 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 $102.33 Median $109.65 Typical High $154.88 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $138.04 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $138.04 |
Where Georgia 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.
Georgia· 13th of 51
$1,349
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.