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 $89.13 Median $1,000.00 Typical High $7,762.47 | Facility | None | $89.13 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $141.25 | Professional | None | $89.13 | $107.15 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Facility | None | $537.03 | $537.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $204.17 | Professional | None | $102.33 | $154.88 | $204.17 |
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 $93.33 Median $165.96 Typical High $602.56 | Facility | None | $93.33 | $165.96 | $602.56 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $213.80 | Professional | None | $114.82 | $154.88 | $213.80 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $213.80 | Professional | None | $102.33 | $154.88 | $213.80 |
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 $44.67 Median $53.70 Typical High $70.79 | Professional | 52 · Reduced service | $44.67 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.38 Typical High $28.18 | Professional | 53 · Discontinued | $17.78 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $79.43 Typical High $104.71 | Professional | 54 · Surgery only | $66.07 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.85 Typical High $21.38 | Professional | 55 · Aftercare only | $13.18 | $15.85 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.72 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.91 | $10.72 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $74.13 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $61.66 | $74.13 | $100.00 |
Where New Mexico sits
The same service costs 3.8 times more in Alaska than in New York. 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· 14th of 51
$155
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.