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 $281.84 Median $1,047.13 Typical High $7,762.47 | Facility | None | $281.84 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $489.78 | Professional | None | $281.84 | $346.74 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $436.52 Typical High $602.56 | Facility | None | $309.03 | $436.52 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $588.84 | Professional | None | $295.12 | $416.87 | $588.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $316.23 Typical High $537.03 | Professional | None | $33.11 | $316.23 | $537.03 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $457.09 Typical High $602.56 | Facility | None | $309.03 | $457.09 | $602.56 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $630.96 | Professional | None | $302.00 | $416.87 | $630.96 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $660.69 | Professional | None | $302.00 | $446.68 | $660.69 |
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 $138.04 Median $173.78 Typical High $239.88 | Professional | 52 · Reduced service | $138.04 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $69.18 Typical High $97.72 | Professional | 53 · Discontinued | $56.23 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $257.04 Typical High $363.08 | Professional | 54 · Surgery only | $208.93 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $51.29 Typical High $72.44 | Professional | 55 · Aftercare only | $41.69 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $34.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $28.18 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $239.88 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $194.98 | $239.88 | $338.84 |
Where New Mexico sits
The same service costs 4.8 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· 28th of 51
$417
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.