How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $199.53 Median $1,047.13 Typical High $7,762.47 | Facility | None | $199.53 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $346.74 | Professional | None | $199.53 | $281.84 | $346.74 |
BCBS Setting Facility Modifier None Typical Low $229.09 Median $6,309.57 Typical High $70,794.58 | Facility | None | $229.09 | $6,309.57 | $70,794.58 |
BCBS Setting Professional Modifier None Typical Low $131.83 Median $251.19 Typical High $354.81 | Professional | None | $131.83 | $251.19 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $602.56 | Facility | None | $208.93 | $251.19 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $489.78 | Professional | None | $229.09 | $346.74 | $489.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $251.19 Typical High $416.87 | Professional | None | $33.11 | $251.19 | $416.87 |
Providence Setting Facility Modifier None Typical Low $208.93 Median $295.12 Typical High $537.03 | Facility | None | $208.93 | $295.12 | $537.03 |
Providence Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $501.19 | Professional | None | $239.88 | $346.74 | $501.19 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $3,019.95 | Facility | None | $346.74 | $707.95 | $3,019.95 |
United Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $501.19 | Professional | None | $213.80 | $338.84 | $501.19 |
6 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 $100.00 Median $123.03 Typical High $173.78 | Professional | 52 · Reduced service | $100.00 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $48.98 Typical High $69.18 | Professional | 53 · Discontinued | $40.74 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $181.97 Typical High $257.04 | Professional | 54 · Surgery only | $151.36 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $37.15 Typical High $51.29 | Professional | 55 · Aftercare only | $30.20 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $24.55 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.95 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $169.82 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $141.25 | $169.82 | $239.88 |
Where New Mexico sits
The same service costs 3.9 times more in Alaska than in Texas. 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· 18th of 51
$339
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.