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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $104.71 | Professional | None | $72.44 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $144.54 | Professional | None | $91.20 | $114.82 | $144.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $125.89 Typical High $125.89 | Professional | None | $33.11 | $125.89 | $125.89 |
Providence Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $128.82 | Facility | None | $120.23 | $120.23 | $128.82 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $151.36 | Professional | None | $91.20 | $114.82 | $151.36 |
United Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $162.18 | Professional | None | $91.20 | $125.89 | $162.18 |
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 $35.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $35.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $14.45 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $10.72 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.24 | $10.47 | $10.47 |
Where New Mexico sits
The same service costs 3.1 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· 15th of 51
$123
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.