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 $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.89 Typical High $23.99 | Professional | None | $20.42 | $20.89 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $42.66 | Facility | None | $21.38 | $21.38 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
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 $21.38 Median $21.38 Typical High $42.66 | Facility | None | $21.38 | $21.38 | $42.66 |
Providence Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
United Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
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 $10.23 Median $10.47 Typical High $12.02 | Professional | 52 · Reduced service | $10.23 | $10.47 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.17 Typical High $4.79 | Professional | 53 · Discontinued | $4.07 | $4.17 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.09 Typical High $3.55 | Professional | 55 · Aftercare only | $3.02 | $3.09 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.09 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.04 | $2.09 | $2.40 |
Where New Mexico sits
The same service costs 1.7 times more in Alaska than in Hawaii. 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
$21.38
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.