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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $616.60 | Professional | None | $489.78 | $616.60 | $616.60 |
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 $239.88 Typical High $524.81 | Professional | None | $60.26 | $239.88 | $524.81 |
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 $245.47 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $245.47 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $97.72 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $72.44 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $48.98 | $61.66 | $61.66 |
Where New Mexico sits
The same service costs 7.1 times more in Wyoming than in North Carolina. 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· 42nd 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.