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 $812.83 Median $1,380.38 Typical High $7,762.47 | Facility | None | $812.83 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,148.15 | Professional | None | $812.83 | $977.24 | $1,148.15 |
BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,621.81 Typical High $7,762.47 | Facility | None | $537.03 | $1,621.81 | $7,762.47 |
BCBS Setting Professional Modifier None Typical Low $457.09 Median $1,000.00 Typical High $1,348.96 | Professional | None | $457.09 | $1,000.00 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,348.96 Typical High $1,819.70 | Facility | None | $776.25 | $1,348.96 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $1,621.81 | Professional | None | $891.25 | $1,348.96 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $851.14 Typical High $1,412.54 | Professional | None | $33.11 | $851.14 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $1,348.96 Typical High $1,949.84 | Facility | None | $741.31 | $1,348.96 | $1,949.84 |
Providence Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $1,698.24 | Professional | None | $977.24 | $1,348.96 | $1,698.24 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $1,698.24 | Professional | None | $851.14 | $1,318.26 | $1,698.24 |
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 $407.38 Median $489.78 Typical High $575.44 | Professional | 52 · Reduced service | $407.38 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $194.98 Typical High $229.09 | Professional | 53 · Discontinued | $162.18 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $741.31 Typical High $870.96 | Professional | 54 · Surgery only | $616.60 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $147.91 Typical High $173.78 | Professional | 55 · Aftercare only | $123.03 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $97.72 Typical High $114.82 | Professional | 56 · Pre-op care only | $81.28 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $691.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $575.44 | $691.83 | $812.83 |
Where New Mexico sits
The same service costs 4.4 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
$1,175
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.