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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $47.86 | Professional | None | $41.69 | $42.66 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $60.26 | Facility | None | $30.20 | $30.20 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $60.26 | Professional | None | $42.66 | $42.66 | $60.26 |
Providence Setting Facility Modifier None Typical Low $30.20 Median $45.71 Typical High $60.26 | Facility | None | $30.20 | $45.71 | $60.26 |
Providence Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
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 $20.42 Median $21.38 Typical High $23.99 | Professional | 52 · Reduced service | $20.42 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.51 Typical High $9.77 | Professional | 53 · Discontinued | $8.32 | $8.51 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.31 Typical High $7.24 | Professional | 55 · Aftercare only | $6.17 | $6.31 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.27 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.17 | $4.27 | $4.79 |
Where New Mexico sits
The same service costs 2.0 times more in Alaska than in New Mexico. 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· 51st of 51
$30.20
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.