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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $602.56 | Professional | None | $478.63 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $954.99 | Facility | None | $478.63 | $478.63 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $602.56 | Professional | None | $398.11 | $398.11 | $602.56 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $954.99 | Facility | None | $478.63 | $478.63 | $954.99 |
Providence Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
United Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $234.42 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $234.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $354.81 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $60.26 | $60.26 |
Where New Mexico sits
The same service costs 1.8 times more in Wyoming than in North Carolina. 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· 45th of 51
$479
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.