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 $117.49 Median $1,047.13 Typical High $7,762.47 | Facility | None | $117.49 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $316.23 | Professional | None | $112.20 | $165.96 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $1,288.25 | Facility | None | $537.03 | $870.96 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $239.88 Typical High $338.84 | Professional | None | $131.83 | $239.88 | $338.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $186.21 Typical High $309.03 | Professional | None | $33.11 | $186.21 | $309.03 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $851.14 Typical High $1,318.26 | Facility | None | $158.49 | $851.14 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $245.47 Typical High $338.84 | Professional | None | $131.83 | $245.47 | $338.84 |
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 $131.83 Median $213.80 Typical High $371.54 | Professional | None | $131.83 | $213.80 | $371.54 |
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 $56.23 Median $83.18 Typical High $158.49 | Professional | 52 · Reduced service | $56.23 | $83.18 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $33.11 Typical High $63.10 | Professional | 53 · Discontinued | $22.39 | $33.11 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $125.89 Typical High $239.88 | Professional | 54 · Surgery only | $85.11 | $125.89 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.12 Typical High $47.86 | Professional | 55 · Aftercare only | $17.38 | $25.12 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.60 Typical High $31.62 | Professional | 56 · Pre-op care only | $11.48 | $16.60 | $31.62 |
Where New Mexico sits
The same service costs 3.8 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
$200
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.