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 $181.97 Median $1,000.00 Typical High $7,762.47 | Facility | None | $181.97 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $363.08 | Professional | None | $181.97 | $234.42 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $213.80 Typical High $602.56 | Facility | None | $177.83 | $213.80 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $426.58 | Professional | None | $177.83 | $257.04 | $426.58 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $257.04 Typical High $426.58 | Professional | None | $33.11 | $257.04 | $426.58 |
Providence Setting Facility Modifier None Typical Low $177.83 Median $245.47 Typical High $537.03 | Facility | None | $177.83 | $245.47 | $537.03 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $426.58 | Professional | None | $177.83 | $257.04 | $426.58 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $181.97 Median $281.84 Typical High $457.09 | Professional | None | $181.97 | $281.84 | $457.09 |
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 $91.20 Median $114.82 Typical High $181.97 | Professional | 52 · Reduced service | $91.20 | $114.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $46.77 Typical High $72.44 | Professional | 53 · Discontinued | $36.31 | $46.77 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $173.78 Typical High $275.42 | Professional | 54 · Surgery only | $134.90 | $173.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $34.67 Typical High $54.95 | Professional | 55 · Aftercare only | $26.92 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.44 Typical High $36.31 | Professional | 56 · Pre-op care only | $18.20 | $23.44 | $36.31 |
Where New Mexico sits
The same service costs 4.0 times more in Alaska 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· 39th of 51
$257
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.