How much rates vary
Facilitymedian $1,202 · 10th to 90th $933 to $7,244Professionalmedian $813 · 10th to 90th $741 to $1,585
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 $741.31 Median $741.31 Typical High $794.33 | Facility | None | $741.31 | $741.31 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $812.83 | Professional | None | $724.44 | $776.25 | $812.83 |
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 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Professional | None | $1,258.93 | $1,258.93 | $1,348.96 |
Capital Blue Cross Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,584.89 Typical High $1,584.89 | Professional | KM · Facial prosthesis, new mold | $1,258.93 | $1,584.89 | $1,584.89 |
Capital Blue Cross Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | KN · Facial prosthesis, prior mold | $537.03 | $660.69 | $660.69 |
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 Facility Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | KM · Facial prosthesis, new mold | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $8,128.31 | Professional | None | $794.33 | $794.33 | $8,128.31 |
Cigna Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | KM · Facial prosthesis, new mold | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | KN · Facial prosthesis, prior mold | $524.81 | $524.81 | $524.81 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $3,090.30 | Professional | None | $1,698.24 | $2,691.53 | $3,090.30 |
Geisinger Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Geisinger Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,698.24 | Professional | None | $891.25 | $1,023.29 | $1,698.24 |
Geisinger Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $831.76 Median $977.24 Typical High $1,621.81 | Professional | KM · Facial prosthesis, new mold | $831.76 | $977.24 | $1,621.81 |
Geisinger Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $354.81 Median $407.38 Typical High $676.08 | Professional | KN · Facial prosthesis, prior mold | $354.81 | $407.38 | $676.08 |
Highmark BCBS Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $4,073.80 | Facility | None | $251.19 | $251.19 | $4,073.80 |
Martin's Point Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Martin's Point Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $812.83 | Professional | None | $724.44 | $794.33 | $812.83 |
Martin's Point 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 |
Martin's Point 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 |
Oscar Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $2,754.23 | Professional | None | $1,862.09 | $2,570.40 | $2,754.23 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,202.26 Median $5,370.32 Typical High $9,332.54 | Facility | None | $1,202.26 | $5,370.32 | $9,332.54 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,202.26 | $1,584.89 |
UPMC Health Plan Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | KM · Facial prosthesis, new mold | $1,513.56 | $1,513.56 | $1,513.56 |
UPMC Health Plan Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | KN · Facial prosthesis, prior mold | $630.96 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Facility | None | $1,995.26 | $1,995.26 | $2,398.83 |
United Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,288.25 | Professional | None | $741.31 | $831.76 | $1,288.25 |
7 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 $109.65 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $79.43 | $85.11 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,659.59 Typical High $1,659.59 | Professional | 50 · Both sides | $1,513.56 | $1,659.59 | $1,659.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $123.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $70.79 | $79.43 | $79.43 |
United Setting Professional Modifier RR · Rental Typical Low $295.12 Median $331.13 Typical High $501.19 | Professional | RR · Rental | $295.12 | $331.13 | $501.19 |
United Setting Professional Modifier UE · Used equipment Typical Low $707.95 Median $794.33 Typical High $1,202.26 | Professional | UE · Used equipment | $707.95 | $794.33 | $1,202.26 |
Where Pennsylvania 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.
Pennsylvania· 48th of 51
$832
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.