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 $380.19 Median $1,380.38 Typical High $7,762.47 | Facility | None | $380.19 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $512.86 | Professional | None | $346.74 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,513.56 | Facility | None | $776.25 | $1,202.26 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $676.08 | Professional | None | $398.11 | $512.86 | $676.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $102.33 Typical High $512.86 | Professional | None | $33.11 | $102.33 | $512.86 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $1,174.90 Typical High $1,819.70 | Facility | None | $416.87 | $1,174.90 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $676.08 | Professional | None | $407.38 | $512.86 | $676.08 |
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 $371.54 Median $524.81 Typical High $724.44 | Professional | None | $371.54 | $524.81 | $724.44 |
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 $173.78 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $173.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $69.18 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $257.04 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $51.29 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $34.67 | $51.29 | $51.29 |
Where New Mexico sits
The same service costs 4.8 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· 25th of 51
$513
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.