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 $158.49 Median $1,047.13 Typical High $7,762.47 | Facility | None | $158.49 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $309.03 | Professional | None | $158.49 | $213.80 | $309.03 |
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 $363.08 | Professional | None | $177.83 | $257.04 | $363.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $213.80 Typical High $354.81 | Professional | None | $33.11 | $213.80 | $354.81 |
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 $380.19 | Professional | None | $177.83 | $257.04 | $380.19 |
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 $173.78 Median $257.04 Typical High $407.38 | Professional | None | $173.78 | $257.04 | $407.38 |
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 $79.43 Median $107.15 Typical High $154.88 | Professional | 52 · Reduced service | $79.43 | $107.15 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $42.66 Typical High $61.66 | Professional | 53 · Discontinued | $31.62 | $42.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $158.49 Typical High $229.09 | Professional | 54 · Surgery only | $117.49 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $31.62 Typical High $45.71 | Professional | 55 · Aftercare only | $23.99 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.38 Typical High $30.90 | Professional | 56 · Pre-op care only | $15.85 | $21.38 | $30.90 |
Where New Mexico sits
The same service costs 3.9 times more in Alaska than in Maryland. 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
$251
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.