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 $144.54 Median $1,047.13 Typical High $7,762.47 | Facility | None | $144.54 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | None | $128.82 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,071.52 Typical High $1,445.44 | Facility | None | $537.03 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $354.81 | Professional | None | $173.78 | $257.04 | $354.81 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $38.02 Typical High $190.55 | Professional | None | $33.11 | $38.02 | $190.55 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $1,071.52 Typical High $1,513.56 | Facility | None | $218.78 | $1,071.52 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $354.81 | Professional | None | $177.83 | $257.04 | $354.81 |
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 $144.54 Median $223.87 Typical High $354.81 | Professional | None | $144.54 | $223.87 | $354.81 |
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 $64.57 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $64.57 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $26.30 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $97.72 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.88 | $19.50 | $19.50 |
Where New Mexico sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 24th of 51
$214
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.