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 $123.03 Median $151.36 Typical High $245.47 | Facility | None | $123.03 | $151.36 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $194.98 | Professional | None | $117.49 | $144.54 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $181.97 | Professional | None | $97.72 | $147.91 | $181.97 |
BCBS Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $162.18 | Professional | None | $87.10 | $147.91 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $173.78 | Facility | None | $141.25 | $141.25 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $245.47 | Professional | None | $125.89 | $177.83 | $245.47 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $194.98 Typical High $239.88 | Professional | None | $33.11 | $194.98 | $239.88 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $154.88 Typical High $190.55 | Facility | None | $117.49 | $154.88 | $190.55 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $245.47 | Professional | None | $125.89 | $177.83 | $245.47 |
United Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $257.04 | Professional | None | $141.25 | $186.21 | $257.04 |
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 $53.70 Median $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $53.70 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.50 Typical High $22.91 | Professional | 55 · Aftercare only | $16.22 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $15.14 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $114.82 Median $165.96 Typical High $213.80 | Professional | 25 · Same-day visit | $114.82 | $165.96 | $213.80 |
Where New Mexico sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 28th of 51
$151
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.