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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $56.23 | Professional | None | $47.86 | $48.98 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $104.71 | Facility | None | $52.48 | $52.48 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $95.50 | Professional | None | $54.95 | $63.10 | $95.50 |
Providence Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $104.71 | Facility | None | $52.48 | $52.48 | $104.71 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
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 $23.99 Median $24.55 Typical High $28.18 | Professional | 52 · Reduced service | $23.99 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.77 Typical High $11.22 | Professional | 53 · Discontinued | $9.55 | $9.77 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.41 Typical High $8.32 | Professional | 55 · Aftercare only | $7.08 | $7.41 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.90 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.79 | $4.90 | $5.62 |
Where New Mexico sits
The same service costs 1.6 times more in Alaska than in Pennsylvania. 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· 36th of 51
$52.48
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.