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 $120.23 Median $1,380.38 Typical High $7,762.47 | Facility | None | $120.23 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | None | $117.49 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $398.11 Typical High $602.56 | Facility | None | $281.84 | $398.11 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $173.78 | Professional | None | $107.15 | $128.82 | $173.78 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $151.36 | Professional | None | $30.20 | $33.11 | $151.36 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $331.13 Typical High $602.56 | Facility | None | $141.25 | $331.13 | $602.56 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $181.97 | Professional | None | $114.82 | $138.04 | $181.97 |
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 $107.15 Median $154.88 Typical High $199.53 | Professional | None | $107.15 | $154.88 | $199.53 |
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 $58.88 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $58.88 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $23.44 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $89.13 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $17.78 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.75 | $18.62 | $18.62 |
Where New Mexico sits
The same service costs 4.8 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· 25th of 51
$145
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.