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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $102.33 | Professional | None | $79.43 | $102.33 | $102.33 |
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 $60.26 Median $436.52 Typical High $933.25 | Professional | None | $60.26 | $436.52 | $933.25 |
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 $39.81 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $39.81 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $15.85 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $12.02 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.94 | $10.23 | $10.23 |
Where New Mexico sits
The same service costs 7.2 times more in Hawaii 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· 8th 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.