How much rates vary
Facilitymedian $933 · 10th to 90th $851 to $2,291Professionalmedian $891 · 10th to 90th $741 to $1,318
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 $537.03 Median $851.14 Typical High $870.96 | Facility | None | $537.03 | $851.14 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,584.89 | Professional | None | $691.83 | $851.14 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $1,737.80 | Facility | None | $1,023.29 | $1,659.59 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,096.48 | Professional | None | $758.58 | $891.25 | $1,096.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | RR · Rental | $91.20 | $91.20 | $91.20 |
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 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $1,148.15 Typical High $2,238.72 | Facility | None | $489.78 | $1,148.15 | $2,238.72 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $1,698.24 Typical High $2,454.71 | Professional | None | $724.44 | $1,698.24 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $2,290.87 | Facility | None | $933.25 | $933.25 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $8,128.31 | Professional | None | $794.33 | $933.25 | $8,128.31 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $331.13 | Professional | None | $275.42 | $275.42 | $331.13 |
United Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,148.15 | Professional | None | $549.54 | $812.83 | $1,148.15 |
United Setting Professional Modifier RR · Rental Typical Low $218.78 Median $323.59 Typical High $446.68 | Professional | RR · Rental | $218.78 | $323.59 | $446.68 |
United Setting Professional Modifier UE · Used equipment Typical Low $512.86 Median $758.58 Typical High $1,047.13 | Professional | UE · Used equipment | $512.86 | $758.58 | $1,047.13 |
8 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 $104.71 Median $125.89 Typical High $239.88 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $53.70 | $85.11 | $85.11 |
Aetna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $234.42 Median $457.09 Typical High $512.86 | Professional | KM · Facial prosthesis, new mold | $234.42 | $457.09 | $512.86 |
Aetna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $100.00 Median $190.55 Typical High $213.80 | Professional | KN · Facial prosthesis, prior mold | $100.00 | $190.55 | $213.80 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,584.89 Typical High $2,951.21 | Professional | KM · Facial prosthesis, new mold | $1,258.93 | $1,584.89 | $2,951.21 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $660.69 Typical High $1,230.27 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $660.69 | $1,230.27 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,230.27 Median $1,258.93 Typical High $1,348.96 | Professional | KM · Facial prosthesis, new mold | $1,230.27 | $1,258.93 | $1,348.96 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $512.86 Median $537.03 Typical High $562.34 | Professional | KN · Facial prosthesis, prior mold | $512.86 | $537.03 | $562.34 |
Where Kentucky 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.
Kentucky· 39th of 51
$891
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.