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 $281.84 Median $1,000.00 Typical High $7,762.47 | Facility | None | $281.84 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $446.68 | Professional | None | $281.84 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $6,165.95 | Facility | None | $602.56 | $4,466.84 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $724.44 | Professional | None | $331.13 | $331.13 | $724.44 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $16,982.44 | Facility | None | $1,995.26 | $5,495.41 | $16,982.44 |
United Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $724.44 | Professional | None | $389.05 | $549.54 | $724.44 |
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 $141.25 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $141.25 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $56.23 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $208.93 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $41.69 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $28.18 | $44.67 | $44.67 |
Where New Mexico sits
The same service costs 4.5 times more in Alaska than in New York. 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
$513
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.