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 $630.96 Median $1,548.82 Typical High $8,709.64 | Facility | None | $630.96 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $912.01 | Professional | None | $630.96 | $758.58 | $912.01 |
BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $8,709.64 Typical High $13,489.63 | Facility | None | $2,398.83 | $8,709.64 | $13,489.63 |
BCBS Setting Professional Modifier None Typical Low $416.87 Median $776.25 Typical High $1,096.48 | Professional | None | $416.87 | $776.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $2,290.87 | Facility | None | $602.56 | $1,513.56 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,288.25 | Professional | None | $691.83 | $1,047.13 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $660.69 Typical High $1,096.48 | Professional | None | $33.11 | $660.69 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $2,290.87 | Facility | None | $602.56 | $1,479.11 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,348.96 | Professional | None | $758.58 | $1,071.52 | $1,348.96 |
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 $691.83 Median $1,023.29 Typical High $1,380.38 | Professional | None | $691.83 | $1,023.29 | $1,380.38 |
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 $316.23 Median $380.19 Typical High $457.09 | Professional | 52 · Reduced service | $316.23 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $125.89 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $575.44 Typical High $691.83 | Professional | 54 · Surgery only | $478.63 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | 55 · Aftercare only | $95.50 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $91.20 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $537.03 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $446.68 | $537.03 | $645.65 |
Where New Mexico sits
The same service costs 4.5 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· 20th of 51
$933
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.