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 $1,000.00 Median $2,089.30 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,089.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $3,801.89 Median $5,128.61 Typical High $5,128.61 | Professional | None | $3,801.89 | $5,128.61 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $16,218.10 Typical High $22,387.21 | Facility | None | $602.56 | $16,218.10 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $4,897.79 Typical High $6,918.31 | Professional | None | $4,073.80 | $4,897.79 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,148.15 Typical High $5,754.40 | Professional | None | $33.11 | $1,148.15 | $5,754.40 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $6,025.60 Typical High $23,442.29 | Facility | None | $602.56 | $6,025.60 | $23,442.29 |
Providence Setting Professional Modifier None Typical Low $4,073.80 Median $4,897.79 Typical High $7,413.10 | Professional | None | $4,073.80 | $4,897.79 | $7,413.10 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $10,232.93 Typical High $27,542.29 | Facility | None | $3,981.07 | $10,232.93 | $27,542.29 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $5,495.41 Typical High $7,413.10 | Professional | None | $3,715.35 | $5,495.41 | $7,413.10 |
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 $1,905.46 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $1,905.46 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $758.58 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $2,884.03 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $575.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $380.19 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $2,691.53 | $3,630.78 | $3,630.78 |
Where New Mexico sits
The same service costs 20.4 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· 27th of 51
$5,129
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.