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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $229.09 | Professional | None | $181.97 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $269.15 | Facility | None | $125.89 | $177.83 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $275.42 | Professional | None | $128.82 | $181.97 | $275.42 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $257.04 | Facility | None | $125.89 | $177.83 | $257.04 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $91.20 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $91.20 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $36.31 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $27.54 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.20 | $22.91 | $22.91 |
Where New Mexico sits
The same service costs 3.6 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· 49th of 51
$126
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.