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 $70.79 Median $1,000.00 Typical High $7,762.47 | Facility | None | $70.79 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $125.89 | Professional | None | $64.57 | $89.13 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $109.65 Typical High $602.56 | Facility | None | $91.20 | $109.65 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $144.54 | Professional | None | $74.13 | $102.33 | $144.54 |
Molina Setting Professional Modifier None Typical Low $17.38 Median $85.11 Typical High $144.54 | Professional | None | $17.38 | $85.11 | $144.54 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $123.03 Typical High $537.03 | Facility | None | $87.10 | $123.03 | $537.03 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $154.88 | Professional | None | $74.13 | $102.33 | $154.88 |
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 $67.61 Median $107.15 Typical High $165.96 | Professional | None | $67.61 | $107.15 | $165.96 |
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 $34.67 Median $44.67 Typical High $61.66 | Professional | 52 · Reduced service | $34.67 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $17.78 Typical High $25.12 | Professional | 53 · Discontinued | $14.13 | $17.78 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $67.61 Typical High $93.33 | Professional | 54 · Surgery only | $52.48 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.49 Typical High $18.62 | Professional | 55 · Aftercare only | $10.47 | $13.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.91 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.08 | $8.91 | $12.59 |
Where New Mexico sits
The same service costs 3.8 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· 28th of 51
$102
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.