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 $89.13 Median $1,071.52 Typical High $7,762.47 | Facility | None | $89.13 | $1,071.52 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $630.96 Typical High $1,348.96 | Professional | None | $87.10 | $630.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $1,288.25 | Facility | None | $537.03 | $870.96 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $831.76 Typical High $1,348.96 | Professional | None | $100.00 | $831.76 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $758.58 Typical High $1,258.93 | Professional | None | $33.11 | $758.58 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $912.01 Typical High $1,318.26 | Facility | None | $251.19 | $912.01 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $100.00 Median $851.14 Typical High $1,348.96 | Professional | None | $100.00 | $851.14 | $1,348.96 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $95.50 Median $707.95 Typical High $1,513.56 | Professional | None | $95.50 | $707.95 | $1,513.56 |
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 $43.65 Median $316.23 Typical High $676.08 | Professional | 52 · Reduced service | $43.65 | $316.23 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $125.89 Typical High $269.15 | Professional | 53 · Discontinued | $17.38 | $125.89 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $478.63 Typical High $1,023.29 | Professional | 54 · Surgery only | $64.57 | $478.63 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $95.50 Typical High $204.17 | Professional | 55 · Aftercare only | $12.88 | $95.50 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $63.10 Typical High $134.90 | Professional | 56 · Pre-op care only | $8.71 | $63.10 | $134.90 |
Where New Mexico sits
The same service costs 14.1 times more in Washington 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· 25th of 51
$759
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.