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 $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $851.14 Typical High $851.14 | Professional | None | $169.82 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $208.93 Typical High $316.23 | Professional | None | $69.18 | $208.93 | $316.23 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $8,912.51 | Facility | None | $4,073.80 | $4,073.80 | $8,912.51 |
United Setting Professional Modifier None Typical Low $87.10 Median $186.21 Typical High $363.08 | Professional | None | $87.10 | $186.21 | $363.08 |
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 $85.11 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $85.11 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $33.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $25.70 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $16.98 | $85.11 | $85.11 |
Where New Mexico sits
The same service costs 7.6 times more in Colorado than in Rhode Island. 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· 31st of 51
$191
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.