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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $144.54 | Professional | None | $104.71 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $52.48 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $20.89 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $15.49 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.47 | $12.30 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | None | $144.54 | $144.54 | $194.98 |
Providence Setting Facility Modifier None Typical Low $107.15 Median $109.65 Typical High $114.82 | Facility | None | $107.15 | $109.65 | $114.82 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $204.17 | Facility | None | $169.82 | $169.82 | $204.17 |
United Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $112.20 | Professional | None | $69.18 | $74.13 | $112.20 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where New Mexico sits
The same service costs 2.6 times more in Montana than in Ohio. 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· 22nd of 51
$123
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.