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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $60.26 Typical High $69.18 | Professional | None | $58.88 | $60.26 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $123.03 | Facility | None | $61.66 | $61.66 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $151.36 | Professional | None | $107.15 | $107.15 | $151.36 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $60.26 Typical High $123.03 | Facility | None | $53.70 | $60.26 | $123.03 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $29.51 Median $30.20 Typical High $34.67 | Professional | 52 · Reduced service | $29.51 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.02 Typical High $13.80 | Professional | 53 · Discontinued | $11.75 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.91 Typical High $10.23 | Professional | 55 · Aftercare only | $8.71 | $8.91 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.03 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.89 | $6.03 | $6.92 |
Where New Mexico sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 20th of 51
$61.66
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.