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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $117.49 | Professional | None | $67.61 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $123.03 | Professional | None | $74.13 | $91.20 | $123.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $97.72 Typical High $97.72 | Professional | None | $33.11 | $97.72 | $97.72 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Facility | None | $100.00 | $100.00 | $107.15 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $125.89 | Professional | None | $75.86 | $91.20 | $125.89 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $204.17 | Facility | None | $91.20 | $91.20 | $204.17 |
United Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $141.25 | Professional | None | $75.86 | $109.65 | $141.25 |
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 $33.88 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $33.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $13.49 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $10.23 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.76 | $11.75 | $11.75 |
Where New Mexico sits
The same service costs 3.0 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· 24th of 51
$97.72
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.