How much rates vary
Facilitymedian $1,096 · 10th to 90th $468 to $2,399Professionalmedian $871 · 10th to 90th $692 to $1,549
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 $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | None | $812.83 | $870.96 | $870.96 |
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 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,819.70 | Facility | None | $1,698.24 | $1,698.24 | $1,819.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,513.56 | Professional | None | $758.58 | $1,148.15 | $1,513.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $91.20 Typical High $117.49 | Professional | RR · Rental | $91.20 | $91.20 | $117.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $676.08 Median $676.08 Typical High $724.44 | Professional | UE · Used equipment | $676.08 | $676.08 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None | $870.96 | $870.96 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $933.25 Typical High $933.25 | Facility | None | $616.60 | $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 $1,202.26 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,698.24 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,122.02 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $912.01 Typical High $1,122.02 | Facility | None | $524.81 | $912.01 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,122.02 | Professional | None | $912.01 | $912.01 | $1,122.02 |
Sentara Setting Facility Modifier None Typical Low $436.52 Median $1,096.48 Typical High $2,570.40 | Facility | None | $436.52 | $1,096.48 | $2,570.40 |
Sentara Setting Professional Modifier None Typical Low $467.74 Median $1,122.02 Typical High $2,238.72 | Professional | None | $467.74 | $1,122.02 | $2,238.72 |
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 $758.58 Median $831.76 Typical High $1,258.93 | Professional | None | $758.58 | $831.76 | $1,258.93 |
United Setting Professional Modifier RR · Rental Typical Low $302.00 Median $331.13 Typical High $501.19 | Professional | RR · Rental | $302.00 | $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 |
13 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 $123.03 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
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 |
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 |
Anthem BCBS Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,122.02 Median $1,122.02 Typical High $1,819.70 | Professional | KM · Facial prosthesis, new mold | $1,122.02 | $1,122.02 | $1,819.70 |
Anthem BCBS Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $467.74 Median $467.74 Typical High $776.25 | Professional | KN · Facial prosthesis, prior mold | $467.74 | $467.74 | $776.25 |
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 |
Kaiser Permanente Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $1,202.26 Median $1,698.24 Typical High $2,187.76 | Professional | KM · Facial prosthesis, new mold | $1,202.26 | $1,698.24 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $1,202.26 Median $1,698.24 Typical High $2,187.76 | Professional | KN · Facial prosthesis, prior mold | $1,202.26 | $1,698.24 | $2,187.76 |
Sentara Setting Professional Modifier KM · Facial prosthesis, new mold Typical Low $912.01 Median $1,202.26 Typical High $2,089.30 | Professional | KM · Facial prosthesis, new mold | $912.01 | $1,202.26 | $2,089.30 |
Sentara Setting Professional Modifier KN · Facial prosthesis, prior mold Typical Low $389.05 Median $501.19 Typical High $891.25 | Professional | KN · Facial prosthesis, prior mold | $389.05 | $501.19 | $891.25 |
Where Virginia 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.
Virginia· 30th 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.