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 $338.84 Median $1,000.00 Typical High $7,762.47 | Facility | None | $338.84 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $512.86 | Professional | None | $338.84 | $407.38 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $1,202.26 | Facility | None | $257.04 | $309.03 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $741.31 | Professional | None | $380.19 | $562.34 | $741.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $257.04 Median $371.54 Typical High $1,288.25 | Facility | None | $257.04 | $371.54 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $776.25 | Professional | None | $416.87 | $575.44 | $776.25 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $812.83 | Professional | None | $389.05 | $588.84 | $812.83 |
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 $169.82 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $169.82 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $81.28 Typical High $102.33 | Professional | 53 · Discontinued | $67.61 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $389.05 | Professional | 54 · Surgery only | $257.04 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $60.26 Typical High $77.62 | Professional | 55 · Aftercare only | $51.29 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $40.74 Typical High $51.29 | Professional | 56 · Pre-op care only | $33.88 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $281.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $239.88 | $281.84 | $363.08 |
Where New Mexico sits
The same service costs 6.0 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· 16th of 51
$537
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.