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 $467.74 Median $1,548.82 Typical High $8,709.64 | Facility | None | $467.74 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $616.60 | Professional | None | $467.74 | $489.78 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,754.40 Typical High $7,943.28 | Facility | None | $602.56 | $5,754.40 | $7,943.28 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $85.11 | Professional | None | $50.12 | $60.26 | $85.11 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $6,025.60 Typical High $8,317.64 | Facility | None | $602.56 | $6,025.60 | $8,317.64 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $977.24 | Professional | None | $501.19 | $707.95 | $977.24 |
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 $234.42 Median $245.47 Typical High $309.03 | Professional | 52 · Reduced service | $234.42 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $123.03 | Professional | 53 · Discontinued | $93.33 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $457.09 | Professional | 54 · Surgery only | $354.81 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $61.66 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $61.66 |
Where New Mexico sits
The same service costs 7.2 times more in Texas than in Pennsylvania. 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
$724
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.