How much rates vary
Facilitymedian $1,549 · 10th to 90th $1,122 to $1,738Professionalmedian $1,122 · 10th to 90th $741 to $1,820
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 $891.25 Median $1,000.00 Typical High $1,000.00 | Professional | None | $891.25 | $1,000.00 | $1,000.00 |
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 |
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 $794.33 Typical High $933.25 | Professional | None | $794.33 | $794.33 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $3,467.37 Typical High $4,365.16 | Professional | None | $1,258.93 | $3,467.37 | $4,365.16 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $1,202.26 Typical High $1,659.59 | Facility | None | $489.78 | $1,202.26 | $1,659.59 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,548.82 | $1,659.59 |
Moda Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $457.09 Median $1,513.56 Typical High $1,584.89 | Professional | KM · Facial prosthesis, new mold | $457.09 | $1,513.56 | $1,584.89 |
Moda Health Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $190.55 Median $602.56 Typical High $660.69 | Professional | KN · Facial prosthesis, prior mold | $190.55 | $602.56 | $660.69 |
Pacific Source Setting Facility Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,621.81 | Facility | None | $1,288.25 | $1,584.89 | $1,621.81 |
Pacific Source Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,659.59 | Facility | None | $933.25 | $1,000.00 | $1,659.59 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $794.33 Typical High $1,584.89 | Professional | None | $79.43 | $794.33 | $1,584.89 |
Providence Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,479.11 Typical High $1,513.56 | Professional | KM · Facial prosthesis, new mold | $1,258.93 | $1,479.11 | $1,513.56 |
Providence Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $616.60 Typical High $645.65 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $616.60 | $645.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,318.26 Median $2,570.40 Typical High $6,309.57 | Facility | None | $1,318.26 | $2,570.40 | $6,309.57 |
Regence BlueShield Setting Facility Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $2,454.71 Typical High $6,025.60 | Facility | KM · Facial prosthesis, new mold | $1,258.93 | $2,454.71 | $6,025.60 |
Regence BlueShield Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $1,047.13 Typical High $2,511.89 | Facility | KN · Facial prosthesis, prior mold | $524.81 | $1,047.13 | $2,511.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,698.24 | $1,819.70 | $1,819.70 |
Regence BlueShield Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,621.81 Median $1,737.80 Typical High $1,737.80 | Professional | KM · Facial prosthesis, new mold | $1,621.81 | $1,737.80 | $1,737.80 |
Regence BlueShield Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $676.08 Median $741.31 Typical High $741.31 | Professional | KN · Facial prosthesis, prior mold | $676.08 | $741.31 | $741.31 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,235.94 | Facility | None | $2,398.83 | $2,398.83 | $3,235.94 |
United Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,445.44 | Professional | None | $691.83 | $741.31 | $1,445.44 |
4 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 $134.90 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier RR · Rental Typical Low $275.42 Median $295.12 Typical High $575.44 | Professional | RR · Rental | $275.42 | $295.12 | $575.44 |
United Setting Professional Modifier UE · Used equipment Typical Low $645.65 Median $707.95 Typical High $1,380.38 | Professional | UE · Used equipment | $645.65 | $707.95 | $1,380.38 |
Where Oregon 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.
Oregon· 14th of 51
$1,318
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.