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 $660.69 Median $1,380.38 Typical High $7,762.47 | Facility | None | $660.69 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $933.25 | Professional | None | $660.69 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,288.25 Typical High $1,513.56 | Facility | None | $537.03 | $1,288.25 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,258.93 | Professional | None | $724.44 | $870.96 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $199.53 Typical High $1,000.00 | Professional | None | $33.11 | $199.53 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,023.29 Typical High $1,513.56 | Facility | None | $537.03 | $1,023.29 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,348.96 | Professional | None | $724.44 | $870.96 | $1,348.96 |
United Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $1,318.26 | Facility | None | $199.53 | $245.47 | $1,318.26 |
United Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,288.25 | Professional | None | $645.65 | $977.24 | $1,288.25 |
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 $331.13 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $331.13 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $131.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $489.78 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $97.72 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $66.07 | $93.33 | $93.33 |
Where New Mexico sits
The same service costs 4.7 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· 22nd of 51
$933
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.