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 $28.84 Typical High $43.65 | Facility | None | $28.84 | $28.84 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $37.15 Typical High $53.70 | Professional | None | $28.84 | $37.15 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $33.11 Typical High $602.56 | Facility | None | $27.54 | $33.11 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $72.44 | Professional | None | $36.31 | $52.48 | $72.44 |
Molina Setting Professional Modifier None Typical Low $7.41 Median $37.15 Typical High $61.66 | Professional | None | $7.41 | $37.15 | $61.66 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $39.81 Typical High $537.03 | Facility | None | $28.84 | $39.81 | $537.03 |
Providence Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $74.13 | Professional | None | $36.31 | $52.48 | $74.13 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $31.62 Median $52.48 Typical High $83.18 | Professional | None | $31.62 | $52.48 | $83.18 |
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 $14.45 Median $18.62 Typical High $26.92 | Professional | 52 · Reduced service | $14.45 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.41 Typical High $10.72 | Professional | 53 · Discontinued | $5.75 | $7.41 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.62 Typical High $8.13 | Professional | 55 · Aftercare only | $4.27 | $5.62 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.72 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.88 | $3.72 | $5.37 |
Where New Mexico sits
The same service costs 3.3 times more in Alaska than in Virginia. 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
$50.12
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.