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 $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $10.96 Typical High $10.96 | Professional | None | $8.71 | $10.96 | $10.96 |
Cigna Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $17.38 | Facility | None | $8.71 | $8.71 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Molina Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $12.02 | Professional | None | $7.94 | $7.94 | $12.02 |
Providence Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $17.38 | Facility | None | $8.71 | $8.71 | $17.38 |
Providence Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
United Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
United Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
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 $4.37 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $4.37 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $1.74 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.29 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.87 | $1.10 | $1.10 |
Where New Mexico sits
The same service costs 1.9 times more in Wyoming than in Mississippi. 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· 38th of 51
$8.71
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.