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 $42.66 Median $1,047.13 Typical High $7,762.47 | Facility | None | $42.66 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $97.72 Typical High $229.09 | Professional | None | $41.69 | $97.72 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Facility | None | $537.03 | $537.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $151.36 Typical High $223.87 | Professional | None | $44.67 | $151.36 | $223.87 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $131.83 Typical High $218.78 | Professional | None | $26.30 | $131.83 | $218.78 |
Providence Setting Facility Modifier None Typical Low $23.99 Median $138.04 Typical High $602.56 | Facility | None | $23.99 | $138.04 | $602.56 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $151.36 Typical High $223.87 | Professional | None | $44.67 | $151.36 | $223.87 |
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 $44.67 Median $109.65 Typical High $245.47 | Professional | None | $44.67 | $109.65 | $245.47 |
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 $20.89 Median $48.98 Typical High $112.20 | Professional | 52 · Reduced service | $20.89 | $48.98 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $19.50 Typical High $45.71 | Professional | 53 · Discontinued | $8.32 | $19.50 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $74.13 Typical High $169.82 | Professional | 54 · Surgery only | $30.90 | $74.13 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $14.79 Typical High $33.88 | Professional | 55 · Aftercare only | $6.17 | $14.79 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $9.77 Typical High $22.91 | Professional | 56 · Pre-op care only | $4.17 | $9.77 | $22.91 |
Where New Mexico sits
The same service costs 4.6 times more in Wisconsin 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· 27th of 51
$132
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.