How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $51.29 Median $1,047.13 Typical High $7,762.47 | Facility | None | $51.29 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $104.71 Typical High $181.97 | Professional | None | $47.86 | $104.71 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
BCBS Setting Facility Modifier None Typical Low $141.25 Median $2,089.30 Typical High $63,095.73 | Facility | None | $141.25 | $2,089.30 | $63,095.73 |
BCBS Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $165.96 | Professional | None | $40.74 | $69.18 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $1,202.26 | Facility | None | $138.04 | $165.96 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $125.89 Typical High $181.97 | Professional | None | $58.88 | $125.89 | $181.97 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $107.15 Typical High $177.83 | Professional | None | $21.38 | $107.15 | $177.83 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $162.18 Typical High $1,288.25 | Facility | None | $72.44 | $162.18 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $125.89 Typical High $181.97 | Professional | None | $58.88 | $125.89 | $181.97 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $2,630.27 | Facility | None | $346.74 | $707.95 | $2,630.27 |
United Setting Professional Modifier None Typical Low $56.23 Median $112.20 Typical High $194.98 | Professional | None | $56.23 | $112.20 | $194.98 |
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 $24.55 Median $42.66 Typical High $91.20 | Professional | 52 · Reduced service | $24.55 | $42.66 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $16.98 Typical High $36.31 | Professional | 53 · Discontinued | $9.77 | $16.98 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $64.57 Typical High $134.90 | Professional | 54 · Surgery only | $37.15 | $64.57 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $12.88 Typical High $27.54 | Professional | 55 · Aftercare only | $7.41 | $12.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $8.51 Typical High $18.20 | Professional | 56 · Pre-op care only | $4.90 | $8.51 | $18.20 |
Where New Mexico sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 31st of 51
$107
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.