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 $77.62 Median $77.62 Typical High $107.15 | Facility | None | $77.62 | $77.62 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $134.90 | Professional | None | $77.62 | $102.33 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $95.50 Typical High $602.56 | Facility | None | $79.43 | $95.50 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $162.18 | Professional | None | $83.18 | $114.82 | $162.18 |
Molina Setting Professional Modifier None Typical Low $18.62 Median $93.33 Typical High $154.88 | Professional | None | $18.62 | $93.33 | $154.88 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $112.20 Typical High $537.03 | Facility | None | $79.43 | $112.20 | $537.03 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $169.82 | Professional | None | $87.10 | $117.49 | $169.82 |
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 $81.28 Median $120.23 Typical High $181.97 | Professional | None | $81.28 | $120.23 | $181.97 |
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 $38.90 Median $50.12 Typical High $67.61 | Professional | 52 · Reduced service | $38.90 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $20.42 Typical High $27.54 | Professional | 53 · Discontinued | $15.49 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.14 Typical High $20.42 | Professional | 55 · Aftercare only | $11.75 | $15.14 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.00 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.76 | $10.00 | $13.49 |
Where New Mexico sits
The same service costs 3.8 times more in Alaska than in Florida. 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
$115
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.