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 $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $8,511.38 Median $8,709.64 Typical High $10,000.00 | Professional | None | $8,511.38 | $8,709.64 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $17,782.79 | Facility | None | $8,912.51 | $8,912.51 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $645.65 | Professional | None | $457.09 | $457.09 | $645.65 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $17,782.79 | Facility | None | $186.21 | $363.08 | $17,782.79 |
Providence Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
United Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
4 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 $4,265.80 Median $4,365.16 Typical High $5,011.87 | Professional | 52 · Reduced service | $4,265.80 | $4,365.16 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,737.80 Typical High $1,995.26 | Professional | 53 · Discontinued | $1,698.24 | $1,737.80 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,288.25 Median $1,318.26 Typical High $1,513.56 | Professional | 55 · Aftercare only | $1,288.25 | $1,318.26 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $870.96 Typical High $1,000.00 | Professional | 56 · Pre-op care only | $851.14 | $870.96 | $1,000.00 |
Where New Mexico sits
The same service costs 26.3 times more in Alaska than in Montana. 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· 25th of 51
$8,913
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.