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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $549.54 | Professional | None | $467.74 | $478.63 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $1,023.29 | Facility | None | $512.86 | $512.86 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Molina Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $758.58 | Professional | None | $537.03 | $537.03 | $758.58 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $1,023.29 | Facility | None | $512.86 | $512.86 | $1,023.29 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
United Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
United Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $234.42 Median $239.88 Typical High $275.42 | Professional | 52 · Reduced service | $234.42 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $72.44 Typical High $81.28 | Professional | 55 · Aftercare only | $69.18 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $54.95 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $54.95 |
Where New Mexico sits
The same service costs 1.6 times more in Alaska than in Idaho. 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· 35th of 51
$513
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.