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 $1,548.82 Typical High $8,709.64 | Facility | None | $245.47 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $446.68 | Professional | None | $245.47 | $302.00 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $363.08 Typical High $1,698.24 | Facility | None | $257.04 | $363.08 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $616.60 | Professional | None | $239.88 | $389.05 | $616.60 |
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 $257.04 Median $446.68 Typical High $2,238.72 | Facility | None | $257.04 | $446.68 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $616.60 | Professional | None | $239.88 | $398.11 | $616.60 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $630.96 | Professional | None | $239.88 | $380.19 | $630.96 |
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 $151.36 Typical High $223.87 | Professional | 52 · Reduced service | $123.03 | $151.36 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $60.26 Typical High $89.13 | Professional | 53 · Discontinued | $48.98 | $60.26 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $229.09 Typical High $331.13 | Professional | 54 · Surgery only | $181.97 | $229.09 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $45.71 Typical High $66.07 | Professional | 55 · Aftercare only | $37.15 | $45.71 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.20 Typical High $44.67 | Professional | 56 · Pre-op care only | $24.55 | $30.20 | $44.67 |
Where New Mexico sits
The same service costs 4.0 times more in Alaska than in New York. 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· 18th 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.