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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $354.81 | Professional | None | $302.00 | $309.03 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $645.65 | Facility | None | $323.59 | $323.59 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $478.63 | Professional | None | $338.84 | $338.84 | $478.63 |
Providence Setting Facility Modifier None Typical Low $10.72 Median $177.83 Typical High $645.65 | Facility | None | $10.72 | $177.83 | $645.65 |
Providence Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
United Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $151.36 Median $154.88 Typical High $177.83 | Professional | 52 · Reduced service | $151.36 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $61.66 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $46.77 Typical High $52.48 | Professional | 55 · Aftercare only | $44.67 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.90 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.20 | $30.90 | $35.48 |
Where New Mexico sits
The same service costs 2.3 times more in Alaska than in Montana. 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· 22nd of 51
$324
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.