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 $50.12 Median $1,000.00 Typical High $7,762.47 | Facility | None | $50.12 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $95.50 | Professional | None | $50.12 | $69.18 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $85.11 Typical High $602.56 | Facility | None | $70.79 | $85.11 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $114.82 | Professional | None | $54.95 | $79.43 | $114.82 |
Molina Setting Professional Modifier None Typical Low $13.18 Median $66.07 Typical High $109.65 | Professional | None | $13.18 | $66.07 | $109.65 |
Providence Setting Facility Modifier None Typical Low $63.10 Median $91.20 Typical High $537.03 | Facility | None | $63.10 | $91.20 | $537.03 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $117.49 | Professional | None | $54.95 | $79.43 | $117.49 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $125.89 | Professional | None | $52.48 | $81.28 | $125.89 |
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 $25.12 Median $32.36 Typical High $46.77 | Professional | 52 · Reduced service | $25.12 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.88 Typical High $19.05 | Professional | 53 · Discontinued | $10.00 | $12.88 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $48.98 Typical High $70.79 | Professional | 54 · Surgery only | $37.15 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.77 Typical High $14.13 | Professional | 55 · Aftercare only | $7.41 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.46 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.01 | $6.46 | $9.33 |
Where New Mexico sits
The same service costs 3.6 times more in Alaska 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· 31st of 51
$79.43
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.