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 $263.03 Median $1,047.13 Typical High $7,762.47 | Facility | None | $263.03 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $363.08 | Professional | None | $234.42 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,698.24 Typical High $2,398.83 | Facility | None | $537.03 | $1,698.24 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $407.38 | Professional | None | $257.04 | $309.03 | $407.38 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $194.98 Typical High $194.98 | Professional | None | $38.90 | $194.98 | $194.98 |
Providence Setting Facility Modifier None Typical Low $208.93 Median $1,288.25 Typical High $2,511.89 | Facility | None | $208.93 | $1,288.25 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $407.38 | Professional | None | $263.03 | $309.03 | $407.38 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $467.74 | Professional | None | $251.19 | $346.74 | $467.74 |
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 $117.49 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $117.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $46.77 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $177.83 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $35.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.44 | $36.31 | $36.31 |
Where New Mexico sits
The same service costs 4.6 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· 30th of 51
$309
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.