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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $50.12 Typical High $50.12 | Professional | None | $38.90 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $257.04 | Facility | None | $125.89 | $125.89 | $257.04 |
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 $131.83 Median $186.21 Typical High $281.84 | Professional | None | $131.83 | $186.21 | $281.84 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $257.04 | Facility | None | $125.89 | $125.89 | $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 $19.50 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $19.50 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $7.94 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $5.89 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.89 | $5.01 | $5.01 |
Where New Mexico sits
The same service costs 25.1 times more in Wyoming than in Kentucky. 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· 14th 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.