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 $138.04 Median $1,380.38 Typical High $7,762.47 | Facility | None | $138.04 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $562.34 Typical High $977.24 | Professional | None | $138.04 | $562.34 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $457.09 Typical High $812.83 | Professional | None | $147.91 | $457.09 | $812.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $446.68 Typical High $741.31 | Professional | None | $33.11 | $446.68 | $741.31 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $851.14 Typical High $851.14 | Facility | None | $128.82 | $851.14 | $851.14 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $501.19 Typical High $954.99 | Professional | None | $154.88 | $501.19 | $954.99 |
United Setting Facility Modifier None Typical Low $229.09 Median $1,096.48 Typical High $1,445.44 | Facility | None | $229.09 | $1,096.48 | $1,445.44 |
United Setting Professional Modifier None Typical Low $131.83 Median $346.74 Typical High $954.99 | Professional | None | $131.83 | $346.74 | $954.99 |
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 $69.18 Median $281.84 Typical High $489.78 | Professional | 52 · Reduced service | $69.18 | $281.84 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $112.20 Typical High $194.98 | Professional | 53 · Discontinued | $27.54 | $112.20 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $426.58 Typical High $724.44 | Professional | 54 · Surgery only | $104.71 | $426.58 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $85.11 Typical High $144.54 | Professional | 55 · Aftercare only | $20.89 | $85.11 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $56.23 Typical High $97.72 | Professional | 56 · Pre-op care only | $13.80 | $56.23 | $97.72 |
Where New Mexico sits
The same service costs 4.0 times more in Wisconsin 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· 33rd of 51
$447
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.