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 $16.22 Median $16.22 Typical High $63.10 | Facility | None | $16.22 | $16.22 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $33.88 Typical High $104.71 | Professional | None | $19.95 | $33.88 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.00 Median $16.98 Typical High $52.48 | Professional | 52 · Reduced service | $10.00 | $16.98 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $6.76 Typical High $20.89 | Professional | 53 · Discontinued | $3.98 | $6.76 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $5.13 Typical High $15.85 | Professional | 55 · Aftercare only | $2.95 | $5.13 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $3.39 Typical High $10.47 | Professional | 56 · Pre-op care only | $2.00 | $3.39 | $10.47 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $54.95 Typical High $81.28 | Professional | None | $17.38 | $54.95 | $81.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $25.70 Median $67.61 Typical High $77.62 | Facility | None | $25.70 | $67.61 | $77.62 |
Providence Setting Professional Modifier None Typical Low $17.38 Median $54.95 Typical High $81.28 | Professional | None | $17.38 | $54.95 | $81.28 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $575.44 | Facility | None | $263.03 | $263.03 | $575.44 |
United Setting Professional Modifier None Typical Low $21.88 Median $46.77 Typical High $104.71 | Professional | None | $21.88 | $46.77 | $104.71 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where New Mexico sits
The same service costs 4.4 times more in Hawaii than in Washington, DC. 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· 27th of 51
$46.77
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.