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 $24.55 Median $24.55 Typical High $77.62 | Facility | None | $24.55 | $24.55 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $131.83 | Professional | None | $29.51 | $51.29 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $25.70 Typical High $64.57 | Professional | 52 · Reduced service | $14.79 | $25.70 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $10.23 Typical High $26.30 | Professional | 53 · Discontinued | $6.03 | $10.23 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $7.76 Typical High $19.50 | Professional | 55 · Aftercare only | $4.47 | $7.76 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $5.13 Typical High $13.18 | Professional | 56 · Pre-op care only | $2.95 | $5.13 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $69.18 Typical High $107.15 | Professional | None | $26.30 | $69.18 | $107.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $87.10 Typical High $100.00 | Facility | None | $39.81 | $87.10 | $100.00 |
Providence Setting Professional Modifier None Typical Low $26.30 Median $69.18 Typical High $107.15 | Professional | None | $26.30 | $69.18 | $107.15 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $575.44 | Facility | None | $263.03 | $263.03 | $575.44 |
United Setting Professional Modifier None Typical Low $33.11 Median $53.70 Typical High $134.90 | Professional | None | $33.11 | $53.70 | $134.90 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where New Mexico sits
The same service costs 3.5 times more in Hawaii than in Maryland. 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· 28th of 51
$61.66
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.