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 $28.84 Median $1,047.13 Typical High $7,762.47 | Facility | None | $28.84 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $43.65 Typical High $46.77 | Professional | None | $28.84 | $43.65 | $46.77 |
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 $21.88 Median $36.31 Typical High $51.29 | Professional | None | $21.88 | $36.31 | $51.29 |
Molina Setting Professional Modifier None Typical Low $4.90 Median $24.55 Typical High $40.74 | Professional | None | $4.90 | $24.55 | $40.74 |
Providence Setting Facility Modifier None Typical Low $27.54 Median $40.74 Typical High $1,202.26 | Facility | None | $27.54 | $40.74 | $1,202.26 |
Providence Setting Professional Modifier None Typical Low $23.44 Median $36.31 Typical High $51.29 | Professional | None | $23.44 | $36.31 | $51.29 |
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 $25.12 Median $38.90 Typical High $50.12 | Professional | None | $25.12 | $38.90 | $50.12 |
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 $14.45 Median $21.88 Typical High $23.44 | Professional | 52 · Reduced service | $14.45 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $8.71 Typical High $9.33 | Professional | 53 · Discontinued | $5.75 | $8.71 | $9.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $33.11 Typical High $34.67 | Professional | 54 · Surgery only | $21.88 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $6.61 Typical High $6.92 | Professional | 55 · Aftercare only | $4.37 | $6.61 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $4.37 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.88 | $4.37 | $4.68 |
Where New Mexico sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 23rd of 51
$39.81
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.