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 $162.18 Median $1,047.13 Typical High $7,762.47 | Facility | None | $162.18 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $281.84 | Professional | None | $162.18 | $194.98 | $281.84 |
BCBS Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $302.00 | Professional | None | $114.82 | $199.53 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $204.17 Typical High $1,202.26 | Facility | None | $169.82 | $204.17 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $398.11 | Professional | None | $190.55 | $275.42 | $398.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $190.55 Typical High $346.74 | Professional | None | $33.11 | $190.55 | $346.74 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $245.47 Typical High $1,288.25 | Facility | None | $162.18 | $245.47 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $407.38 | Professional | None | $199.53 | $275.42 | $407.38 |
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 $181.97 Median $281.84 Typical High $416.87 | Professional | None | $181.97 | $281.84 | $416.87 |
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 $81.28 Median $97.72 Typical High $141.25 | Professional | 52 · Reduced service | $81.28 | $97.72 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $38.90 Typical High $56.23 | Professional | 53 · Discontinued | $32.36 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $147.91 Typical High $213.80 | Professional | 54 · Surgery only | $120.23 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $29.51 Typical High $42.66 | Professional | 55 · Aftercare only | $23.99 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.50 Typical High $28.18 | Professional | 56 · Pre-op care only | $16.22 | $19.50 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $138.04 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $112.20 | $138.04 | $199.53 |
Where New Mexico sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$269
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.