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 $112.20 Median $158.49 Typical High $190.55 | Facility | None | $112.20 | $158.49 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $213.80 | Professional | None | $141.25 | $162.18 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $177.83 | Professional | None | $134.90 | $158.49 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $269.15 | Professional | None | $138.04 | $199.53 | $269.15 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $229.09 | Professional | None | $138.04 | $194.98 | $229.09 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $190.55 Typical High $245.47 | Facility | None | $131.83 | $190.55 | $245.47 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $275.42 | Professional | None | $138.04 | $199.53 | $275.42 |
United Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $288.40 | Professional | None | $158.49 | $223.87 | $288.40 |
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 $56.23 Median $79.43 Typical High $91.20 | Professional | 52 · Reduced service | $56.23 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.44 Typical High $27.54 | Professional | 55 · Aftercare only | $16.98 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.85 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.22 | $15.85 | $18.62 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $134.90 Median $158.49 Typical High $177.83 | Professional | 25 · Same-day visit | $134.90 | $158.49 | $177.83 |
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· 14th of 51
$186
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.