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 $52.48 Median $1,047.13 Typical High $7,762.47 | Facility | None | $52.48 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $275.42 | Professional | None | $52.48 | $77.62 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Facility | None | $537.03 | $537.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $154.88 Typical High $295.12 | Professional | None | $58.88 | $154.88 | $295.12 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $173.78 Typical High $288.40 | Professional | None | $33.11 | $173.78 | $288.40 |
Providence Setting Facility Modifier None Typical Low $138.04 Median $234.42 Typical High $602.56 | Facility | None | $138.04 | $234.42 | $602.56 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $169.82 Typical High $295.12 | Professional | None | $58.88 | $169.82 | $295.12 |
United Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $1,318.26 | Facility | None | $199.53 | $245.47 | $1,318.26 |
United Setting Professional Modifier None Typical Low $56.23 Median $141.25 Typical High $295.12 | Professional | None | $56.23 | $141.25 | $295.12 |
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 $25.70 Median $38.90 Typical High $138.04 | Professional | 52 · Reduced service | $25.70 | $38.90 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $15.49 Typical High $54.95 | Professional | 53 · Discontinued | $10.47 | $15.49 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $58.88 Typical High $204.17 | Professional | 54 · Surgery only | $38.90 | $58.88 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $11.75 Typical High $41.69 | Professional | 55 · Aftercare only | $7.76 | $11.75 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.76 Typical High $27.54 | Professional | 56 · Pre-op care only | $5.25 | $7.76 | $27.54 |
Where New Mexico sits
The same service costs 4.6 times more in Iowa than in Kentucky. 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· 23rd of 51
$174
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.