How much rates vary
Facilitymedian $1,585 · 10th to 90th $933 to $2,754Professionalmedian $1,380 · 10th to 90th $741 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 Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,380.38 | $1,380.38 |
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 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,691.53 | Facility | None | $1,288.25 | $1,584.89 | $2,691.53 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,737.80 | $1,819.70 |
BCBS Idaho Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,122.02 Median $1,659.59 Typical High $1,737.80 | Professional | KM · Facial prosthesis, new mold | $1,122.02 | $1,659.59 | $1,737.80 |
BCBS Idaho Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $467.74 Median $707.95 Typical High $741.31 | Professional | KN · Facial prosthesis, prior mold | $467.74 | $707.95 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Facility | None | $933.25 | $933.25 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | None | $794.33 | $794.33 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $478.63 Median $1,380.38 Typical High $1,659.59 | Facility | None | $478.63 | $1,380.38 | $1,659.59 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,380.38 | $1,584.89 | $1,737.80 |
Moda Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $457.09 Median $1,513.56 Typical High $1,659.59 | Professional | KM · Facial prosthesis, new mold | $457.09 | $1,513.56 | $1,659.59 |
Moda Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $190.55 Median $630.96 Typical High $707.95 | Professional | KN · Facial prosthesis, prior mold | $190.55 | $630.96 | $707.95 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,202.26 Typical High $1,412.54 | Professional | None | $30.20 | $1,202.26 | $1,412.54 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $100,000.00 | Facility | None | $1,348.96 | $2,089.30 | $100,000.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $117,489.76 | Professional | None | $1,659.59 | $2,089.30 | $117,489.76 |
MountainHealth Co-op Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,202.26 Median $1,659.59 Typical High $1,659.59 | Professional | KM · Facial prosthesis, new mold | $1,202.26 | $1,659.59 | $1,659.59 |
MountainHealth Co-op Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $501.19 Median $707.95 Typical High $707.95 | Professional | KN · Facial prosthesis, prior mold | $501.19 | $707.95 | $707.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $2,398.83 | Facility | None | $1,548.82 | $1,584.89 | $2,398.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,174.90 | $1,737.80 |
Regence BlueShield Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,122.02 Median $1,122.02 Typical High $1,659.59 | Professional | KM · Facial prosthesis, new mold | $1,122.02 | $1,122.02 | $1,659.59 |
Regence BlueShield Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $467.74 Median $467.74 Typical High $707.95 | Professional | KN · Facial prosthesis, prior mold | $467.74 | $467.74 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $2,137.96 | Facility | None | $1,584.89 | $1,659.59 | $2,137.96 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,659.59 | $1,819.70 |
Select Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,023.29 Median $1,584.89 Typical High $1,737.80 | Professional | KM · Facial prosthesis, new mold | $1,023.29 | $1,584.89 | $1,737.80 |
Select Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $436.52 Median $660.69 Typical High $724.44 | Professional | KN · Facial prosthesis, prior mold | $436.52 | $660.69 | $724.44 |
United Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,148.15 | Professional | None | $691.83 | $741.31 | $1,148.15 |
5 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 $158.49 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $158.49 | $204.17 | $204.17 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,230.27 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,230.27 | $1,288.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $158.49 | $204.17 | $204.17 |
United Setting Professional Modifier RR · Rental Typical Low $275.42 Median $295.12 Typical High $457.09 | Professional | RR · Rental | $275.42 | $295.12 | $457.09 |
United Setting Professional Modifier UE · Used equipment Typical Low $645.65 Median $707.95 Typical High $1,071.52 | Professional | UE · Used equipment | $645.65 | $707.95 | $1,071.52 |
Where Idaho 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.
Idaho· 10th of 51
$1,413
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.