How much rates vary
Facilitymedian $1,514 · 10th to 90th $933 to $2,344Professionalmedian $912 · 10th to 90th $794 to $1,698
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 $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,621.81 | Professional | None | $794.33 | $794.33 | $1,621.81 |
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 $1,348.96 Median $1,698.24 Typical High $1,778.28 | Facility | None | $1,348.96 | $1,698.24 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,698.24 | Professional | None | $912.01 | $912.01 | $1,698.24 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,258.93 Typical High $1,819.70 | Professional | KM · Facial prosthesis, new mold | $1,258.93 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $776.25 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $776.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $91.20 Typical High $128.82 | Professional | RR · Rental | $91.20 | $91.20 | $128.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $676.08 Median $676.08 Typical High $1,000.00 | Professional | UE · Used equipment | $676.08 | $676.08 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $2,454.71 | Facility | None | $954.99 | $2,238.72 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,698.24 | Facility | None | $933.25 | $1,000.00 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $8,128.31 | Professional | None | $794.33 | $1,000.00 | $8,128.31 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,380.38 Typical High $1,905.46 | Professional | KM · Facial prosthesis, new mold | $1,258.93 | $1,380.38 | $1,905.46 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $575.44 Typical High $794.33 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $575.44 | $794.33 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,511.89 Typical High $5,248.07 | Facility | None | $912.01 | $2,511.89 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,380.38 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,023.29 Median $1,348.96 Typical High $2,238.72 | Professional | KM · Facial prosthesis, new mold | $1,023.29 | $1,348.96 | $2,238.72 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $426.58 Median $562.34 Typical High $954.99 | Professional | KN · Facial prosthesis, prior mold | $426.58 | $562.34 | $954.99 |
United Setting Professional Modifier None Typical Low $489.78 Median $831.76 Typical High $1,380.38 | Professional | None | $489.78 | $831.76 | $1,380.38 |
United Setting Professional Modifier RR · Rental Typical Low $199.53 Median $331.13 Typical High $549.54 | Professional | RR · Rental | $199.53 | $331.13 | $549.54 |
United Setting Professional Modifier UE · Used equipment Typical Low $467.74 Median $794.33 Typical High $1,318.26 | Professional | UE · Used equipment | $467.74 | $794.33 | $1,318.26 |
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 $117.49 Median $117.49 Typical High $245.47 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
Where Indiana 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.
Indiana· 36th of 51
$912
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.