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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $147.91 Typical High $169.82 | Professional | None | $144.54 | $147.91 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $257.04 | Facility | None | $125.89 | $125.89 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $85.11 | Professional | None | $50.12 | $60.26 | $85.11 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $257.04 | Facility | None | $125.89 | $125.89 | $257.04 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $72.44 Median $74.13 Typical High $85.11 | Professional | 52 · Reduced service | $72.44 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $29.51 Typical High $33.88 | Professional | 53 · Discontinued | $28.84 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $25.12 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.79 Typical High $16.98 | Professional | 56 · Pre-op care only | $14.45 | $14.79 | $16.98 |
Where New Mexico sits
The same service costs 2.5 times more in Alaska than in North Carolina. 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· 43rd of 51
$126
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.