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 $398.11 Median $1,047.13 Typical High $7,762.47 | Facility | None | $398.11 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $512.86 | Professional | None | $354.81 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $707.95 | Facility | None | $537.03 | $602.56 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $660.69 | Professional | None | $371.54 | $446.68 | $660.69 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $758.58 Typical High $758.58 | Professional | None | $151.36 | $758.58 | $758.58 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $537.03 Typical High $707.95 | Facility | None | $251.19 | $537.03 | $707.95 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $645.65 | Professional | None | $380.19 | $446.68 | $645.65 |
United Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $1,318.26 | Facility | None | $199.53 | $245.47 | $1,318.26 |
United Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $707.95 | Professional | None | $346.74 | $537.03 | $707.95 |
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 $177.83 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $177.83 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $70.79 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $263.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $52.48 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $35.48 | $51.29 | $51.29 |
Where New Mexico sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 26th of 51
$513
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.