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 $251.19 Median $1,000.00 Typical High $7,762.47 | Facility | None | $251.19 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $346.74 | Professional | None | $245.47 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $707.95 | Facility | None | $537.03 | $602.56 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $426.58 | Professional | None | $269.15 | $363.08 | $426.58 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $288.40 Typical High $302.00 | Professional | None | $57.54 | $288.40 | $302.00 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $125,892.54 Typical High $251,188.64 | Facility | None | $602.56 | $125,892.54 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $426.58 | Professional | None | $275.42 | $363.08 | $426.58 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,412.54 Typical High $10,471.29 | Facility | None | $407.38 | $1,412.54 | $10,471.29 |
United Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $426.58 | Professional | None | $229.09 | $309.03 | $426.58 |
3 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 54 · Surgery only Typical Low $181.97 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $181.97 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $36.31 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $24.55 | $34.67 | $34.67 |
Where New Mexico sits
The same service costs 8.1 times more in New York than in Missouri. 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· 30th of 51
$302
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.