How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $83.18 Median $1,047.13 Typical High $7,762.47 | Facility | None | $83.18 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $229.09 Typical High $407.38 | Professional | None | $81.28 | $229.09 | $407.38 |
BCBS Setting Professional Modifier None Typical Low $97.72 Median $208.93 Typical High $426.58 | Professional | None | $97.72 | $208.93 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $426.58 | Professional | None | $91.20 | $151.36 | $426.58 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $251.19 Typical High $630.96 | Professional | None | $33.11 | $251.19 | $630.96 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $371.54 Typical High $467.74 | Facility | None | $162.18 | $371.54 | $467.74 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $489.78 | Professional | None | $93.33 | $177.83 | $489.78 |
United Setting Facility Modifier None Typical Low $229.09 Median $1,096.48 Typical High $1,445.44 | Facility | None | $229.09 | $1,096.48 | $1,445.44 |
United Setting Professional Modifier None Typical Low $87.10 Median $208.93 Typical High $501.19 | Professional | None | $87.10 | $208.93 | $501.19 |
5 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 52 · Reduced service Typical Low $41.69 Median $125.89 Typical High $204.17 | Professional | 52 · Reduced service | $41.69 | $125.89 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $50.12 Typical High $81.28 | Professional | 53 · Discontinued | $16.60 | $50.12 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $186.21 Typical High $302.00 | Professional | 54 · Surgery only | $63.10 | $186.21 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $37.15 Typical High $60.26 | Professional | 55 · Aftercare only | $12.59 | $37.15 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $25.12 Typical High $40.74 | Professional | 56 · Pre-op care only | $8.32 | $25.12 | $40.74 |
Where New Mexico sits
The same service costs 4.2 times more in Washington than in Virginia. 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.
New Mexico· 34th of 51
$219
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.