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 $1.20 Median $1.20 Typical High $1.20 | Facility | None | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.41 | Professional | None | $1.20 | $1.20 | $1.41 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $269.15 | Facility | None | $125.89 | $177.83 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $60.26 | Professional | None | $50.12 | $60.26 | $60.26 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $257.04 | Facility | None | $125.89 | $177.83 | $257.04 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $0.62 Median $0.62 Typical High $0.71 | Professional | 52 · Reduced service | $0.62 | $0.62 | $0.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.24 Typical High $0.28 | Professional | 53 · Discontinued | $0.24 | $0.24 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.21 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.14 |
Where New Mexico sits
The same service costs 14.8 times more in North Dakota than in New Jersey. 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· 32nd of 51
$126
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.