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 $6.31 Median $1,000.00 Typical High $7,762.47 | Facility | None | $6.31 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $9.33 Typical High $9.33 | Professional | None | $6.31 | $9.33 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $10.00 Typical High $14.79 | Professional | None | $8.71 | $10.00 | $14.79 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $45.71 Typical High $45.71 | Professional | None | $27.54 | $45.71 | $45.71 |
Providence Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $15.49 | Facility | None | $14.79 | $14.79 | $15.49 |
Providence Setting Professional Modifier None Typical Low $8.71 Median $10.00 Typical High $15.14 | Professional | None | $8.71 | $10.00 | $15.14 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $562.34 | Facility | None | $251.19 | $251.19 | $562.34 |
United Setting Professional Modifier None Typical Low $8.32 Median $11.75 Typical High $16.22 | Professional | None | $8.32 | $11.75 | $16.22 |
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 $3.16 Median $4.68 Typical High $4.68 | Professional | 52 · Reduced service | $3.16 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.26 Median $1.86 Typical High $1.86 | Professional | 53 · Discontinued | $1.26 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.79 Median $6.92 Typical High $6.92 | Professional | 54 · Surgery only | $4.79 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $1.38 Typical High $1.38 | Professional | 55 · Aftercare only | $0.95 | $1.38 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.63 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.63 | $0.93 | $0.93 |
Where New Mexico sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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· 20th of 51
$11.48
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.