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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $251.19 | Professional | None | $158.49 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $123.03 Typical High $125.89 | Professional | 52 · Reduced service | $79.43 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $31.62 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $37.15 Typical High $38.02 | Professional | 55 · Aftercare only | $23.99 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $24.55 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.85 | $24.55 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $223.87 Typical High $229.09 | Facility | None | $213.80 | $223.87 | $229.09 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $309.03 | Facility | None | $263.03 | $263.03 | $309.03 |
United Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $169.82 | Professional | None | $104.71 | $112.20 | $169.82 |
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 2.5 times more in Alaska than in Utah. 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· 20th of 51
$191
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.