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 $131.83 Median $1,047.13 Typical High $7,762.47 | Facility | None | $131.83 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $181.97 | Professional | None | $117.49 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $758.58 Typical High $1,071.52 | Facility | None | $602.56 | $758.58 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $208.93 | Professional | None | $125.89 | $151.36 | $208.93 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $28.84 Typical High $28.84 | Professional | None | $5.89 | $28.84 | $28.84 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $707.95 Typical High $1,096.48 | Facility | None | $165.96 | $707.95 | $1,096.48 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $208.93 | Professional | None | $131.83 | $151.36 | $208.93 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $234.42 | Professional | None | $125.89 | $173.78 | $234.42 |
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 $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $58.88 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $23.44 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $89.13 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $17.78 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.75 | $18.20 | $18.20 |
Where New Mexico sits
The same service costs 6.0 times more in Alaska than in Kentucky. 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· 27th of 51
$155
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.