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 $1,000.00 Median $2,041.74 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,202.26 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $7,585.78 | Facility | None | $602.56 | $5,370.32 | $7,585.78 |
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 $5,623.41 Typical High $7,943.28 | Facility | None | $602.56 | $5,623.41 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $16,982.44 | Facility | None | $1,995.26 | $5,495.41 | $16,982.44 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,258.93 | $1,737.80 | $2,454.71 |
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 $575.44 Median $602.56 Typical High $758.58 | Professional | 52 · Reduced service | $575.44 | $602.56 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $302.00 | Professional | 53 · Discontinued | $234.42 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $1,148.15 | Professional | 54 · Surgery only | $870.96 | $912.01 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $151.36 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $151.36 |
Where New Mexico sits
The same service costs 5.9 times more in Texas 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
$1,738
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.