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 $245.47 Median $1,047.13 Typical High $7,762.47 | Facility | None | $245.47 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $323.59 | Professional | None | $245.47 | $251.19 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $14,454.40 Typical High $19,952.62 | Facility | None | $602.56 | $14,454.40 | $19,952.62 |
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 $15,135.61 Typical High $20,892.96 | Facility | None | $602.56 | $15,135.61 | $20,892.96 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $24,547.09 | Facility | None | $1,995.26 | $5,495.41 | $24,547.09 |
United Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $512.86 | Professional | None | $263.03 | $371.54 | $512.86 |
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 $123.03 Median $125.89 Typical High $158.49 | Professional | 52 · Reduced service | $123.03 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $51.29 Typical High $64.57 | Professional | 53 · Discontinued | $48.98 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $239.88 | Professional | 54 · Surgery only | $186.21 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $47.86 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.70 Typical High $32.36 | Professional | 56 · Pre-op care only | $24.55 | $25.70 | $32.36 |
Where New Mexico sits
The same service costs 9.5 times more in Arkansas 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· 22nd of 51
$389
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.