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 $89.13 Median $1,047.13 Typical High $7,762.47 | Facility | None | $89.13 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $295.12 | Professional | None | $85.11 | $141.25 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,659.59 Typical High $2,290.87 | Facility | None | $537.03 | $1,659.59 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $295.12 | Professional | None | $97.72 | $213.80 | $295.12 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $169.82 Typical High $281.84 | Professional | None | $33.11 | $169.82 | $281.84 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $1,288.25 Typical High $2,398.83 | Facility | None | $112.20 | $1,288.25 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $295.12 | Professional | None | $97.72 | $213.80 | $295.12 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $5,011.87 | Facility | None | $575.44 | $1,174.90 | $5,011.87 |
United Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $323.59 | Professional | None | $93.33 | $177.83 | $323.59 |
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 $42.66 Median $70.79 Typical High $147.91 | Professional | 52 · Reduced service | $42.66 | $70.79 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $28.18 Typical High $58.88 | Professional | 53 · Discontinued | $17.38 | $28.18 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $104.71 Typical High $223.87 | Professional | 54 · Surgery only | $64.57 | $104.71 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $20.89 Typical High $44.67 | Professional | 55 · Aftercare only | $12.88 | $20.89 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $14.13 Typical High $29.51 | Professional | 56 · Pre-op care only | $8.91 | $14.13 | $29.51 |
Where New Mexico sits
The same service costs 4.5 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· 34th of 51
$170
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.