How much rates vary
Facilitymedian $933 · 10th to 90th $692 to $1,622Professionalmedian $933 · 10th to 90th $708 to $13,804
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 $707.95 Median $707.95 Typical High $758.58 | Facility | None | $707.95 | $707.95 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,412.54 | Professional | None | $707.95 | $707.95 | $1,412.54 |
BCBS Texas Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Christus Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $13,803.84 Typical High $13,803.84 | Professional | None | $8,912.51 | $13,803.84 | $13,803.84 |
Moda Health Setting Facility Modifier None Typical Low $478.63 Median $912.01 Typical High $1,621.81 | Facility | None | $478.63 | $912.01 | $1,621.81 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,412.54 | Professional | None | $707.95 | $707.95 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $1,071.52 Typical High $1,071.52 | Professional | None | $81.28 | $1,071.52 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,621.81 | Facility | None | $691.83 | $933.25 | $1,621.81 |
Providence Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | None | $794.33 | $794.33 | $933.25 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,995.26 | Facility | None | $1,698.24 | $1,698.24 | $1,995.26 |
United Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,122.02 | Professional | None | $616.60 | $933.25 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
18 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 $104.71 Typical High $208.93 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $141.25 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $141.25 |
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 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 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 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $208.93 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $141.25 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $141.25 |
Moda Health Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $457.09 Median $457.09 Typical High $851.14 | Professional | KM · Facial prosthesis, new mold | $457.09 | $457.09 | $851.14 |
Moda Health 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 |
Providence 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 |
Providence 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 |
Providence 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 |
Providence 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 |
United Setting Professional Modifier RR · Rental Typical Low $245.47 Median $371.54 Typical High $446.68 | Professional | RR · Rental | $245.47 | $371.54 | $446.68 |
United Setting Professional Modifier UE · Used equipment Typical Low $588.84 Median $891.25 Typical High $1,047.13 | Professional | UE · Used equipment | $588.84 | $891.25 | $1,047.13 |
Where Texas 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.
Texas· 31st of 51
$933
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.