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 $2,570.40 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,570.40 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $7,585.78 | Facility | None | $602.56 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $3,311.31 Typical High $4,897.79 | Professional | None | $2,818.38 | $3,311.31 | $4,897.79 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $831.76 Typical High $4,168.69 | Professional | None | $33.11 | $831.76 | $4,168.69 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $4,168.69 Typical High $7,943.28 | Facility | None | $602.56 | $4,168.69 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $2,818.38 Median $3,311.31 Typical High $5,248.07 | Professional | None | $2,818.38 | $3,311.31 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,348.96 | $4,786.30 | $14,125.38 |
United Setting Professional Modifier None Typical Low $2,570.40 Median $3,890.45 Typical High $5,248.07 | Professional | None | $2,570.40 | $3,890.45 | $5,248.07 |
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 $1,288.25 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,288.25 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $524.81 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,949.84 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $389.05 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $257.04 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,630.27 | $2,630.27 |
Where New Mexico sits
The same service costs 19.1 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· 25th of 51
$3,715
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.