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 $123.03 Median $1,047.13 Typical High $7,762.47 | Facility | None | $123.03 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $173.78 | Professional | None | $109.65 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $5,128.61 Typical High $7,079.46 | Facility | None | $537.03 | $5,128.61 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $208.93 | Professional | None | $125.89 | $151.36 | $208.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.88 Typical High $169.82 | Professional | None | $33.11 | $33.88 | $169.82 |
Providence Setting Facility Modifier None Typical Low $138.04 Median $1,288.25 Typical High $7,413.10 | Facility | None | $138.04 | $1,288.25 | $7,413.10 |
Providence Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $213.80 | Professional | None | $134.90 | $162.18 | $213.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $12,022.64 | Facility | None | $1,230.27 | $3,235.94 | $12,022.64 |
United Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $229.09 | Professional | None | $120.23 | $165.96 | $229.09 |
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 $54.95 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $54.95 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $21.88 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $83.18 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $16.60 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.96 | $17.38 | $17.38 |
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· 19th 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.