How much rates vary
Facilitymedian $2,818 · 10th to 90th $933 to $7,244Professionalmedian $1,202 · 10th to 90th $813 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 $954.99 Median $1,000.00 Typical High $1,659.59 | Facility | None | $954.99 | $1,000.00 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,659.59 | Professional | None | $954.99 | $954.99 | $1,659.59 |
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 Michigan Setting Facility Modifier None Typical Low $1,995.26 Median $4,897.79 Typical High $9,332.54 | Facility | None | $1,995.26 | $4,897.79 | $9,332.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,584.89 | $1,659.59 | $1,659.59 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $1,000.00 Typical High $1,047.13 | Facility | None | $426.58 | $1,000.00 | $1,047.13 |
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 $933.25 Typical High $1,659.59 | Professional | None | $794.33 | $933.25 | $1,659.59 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $3,235.94 Typical High $3,548.13 | Facility | None | $954.99 | $3,235.94 | $3,548.13 |
Health Alliance Plan Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $1,698.24 | Professional | None | $851.14 | $1,318.26 | $1,698.24 |
Health Alliance Plan Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $457.09 Median $1,258.93 Typical High $1,621.81 | Professional | KM · Facial prosthesis, new mold | $457.09 | $1,258.93 | $1,621.81 |
Health Alliance Plan Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $190.55 Median $524.81 Typical High $676.08 | Professional | KN · Facial prosthesis, prior mold | $190.55 | $524.81 | $676.08 |
Priority Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Priority Health Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,659.59 | Professional | None | $933.25 | $1,122.02 | $1,659.59 |
Priority Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Professional | KM · Facial prosthesis, new mold | $1,258.93 | $1,258.93 | $1,318.26 |
Priority Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $549.54 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,398.83 | Facility | None | $1,698.24 | $1,995.26 | $2,398.83 |
United Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,122.02 | Professional | None | $616.60 | $794.33 | $1,122.02 |
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 $141.25 Median $141.25 Typical High $251.19 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $165.96 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $165.96 |
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 |
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 |
BCBS Michigan Setting Professional Modifier RR · Rental Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | RR · Rental | $1,659.59 | $1,659.59 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $141.25 |
United Setting Professional Modifier RR · Rental Typical Low $245.47 Median $316.23 Typical High $457.09 | Professional | RR · Rental | $245.47 | $316.23 | $457.09 |
United Setting Professional Modifier UE · Used equipment Typical Low $588.84 Median $758.58 Typical High $1,071.52 | Professional | UE · Used equipment | $588.84 | $758.58 | $1,071.52 |
Where Michigan 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.
Michigan· 17th of 51
$1,202
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.