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 $112.20 Median $1,047.13 Typical High $7,762.47 | Facility | None | $112.20 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $173.78 | Professional | None | $107.15 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $537.03 Typical High $707.95 | Facility | None | $158.49 | $537.03 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $169.82 | Professional | None | $112.20 | $128.82 | $169.82 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $138.04 Typical High $138.04 | Professional | None | $33.11 | $138.04 | $138.04 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $602.56 Typical High $1,445.44 | Facility | None | $158.49 | $602.56 | $1,445.44 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $177.83 | Professional | None | $112.20 | $131.83 | $177.83 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $204.17 | Professional | None | $104.71 | $147.91 | $204.17 |
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 $53.70 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $53.70 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $21.38 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $79.43 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $15.85 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.72 | $17.38 | $17.38 |
Where New Mexico sits
The same service costs 4.0 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· 22nd of 51
$141
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.