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 $43.65 Median $43.65 Typical High $85.11 | Facility | None | $43.65 | $43.65 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $104.71 | Professional | None | $43.65 | $66.07 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $100.00 Typical High $602.56 | Facility | None | $83.18 | $100.00 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $81.28 Typical High $125.89 | Professional | None | $48.98 | $81.28 | $125.89 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $74.13 Typical High $123.03 | Professional | None | $14.79 | $74.13 | $123.03 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $104.71 Typical High $537.03 | Facility | None | $72.44 | $104.71 | $537.03 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $87.10 Typical High $128.82 | Professional | None | $48.98 | $87.10 | $128.82 |
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 $47.86 Median $77.62 Typical High $138.04 | Professional | None | $47.86 | $77.62 | $138.04 |
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 $21.38 Median $33.11 Typical High $52.48 | Professional | 52 · Reduced service | $21.38 | $33.11 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $13.49 Typical High $20.89 | Professional | 53 · Discontinued | $8.71 | $13.49 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.00 Typical High $15.85 | Professional | 55 · Aftercare only | $6.46 | $10.00 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.61 Typical High $10.47 | Professional | 56 · Pre-op care only | $4.37 | $6.61 | $10.47 |
Where New Mexico sits
The same service costs 3.9 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· 30th of 51
$81.28
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.