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 $1,778.28 Median $1,778.28 Typical High $2,187.76 | Facility | None | $1,778.28 | $1,778.28 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,778.28 | $2,290.87 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $1,584.89 | Facility | None | $602.56 | $1,122.02 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,691.53 Typical High $3,801.89 | Professional | None | $2,041.74 | $2,691.53 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,819.70 Typical High $3,019.95 | Professional | None | $33.11 | $1,819.70 | $3,019.95 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,348.96 Typical High $3,630.78 | Facility | None | $602.56 | $1,348.96 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $2,041.74 Median $2,818.38 Typical High $3,981.07 | Professional | None | $2,041.74 | $2,818.38 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,348.96 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $4,073.80 | Professional | None | $1,905.46 | $2,951.21 | $4,073.80 |
5 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 $891.25 Median $1,122.02 Typical High $1,348.96 | Professional | 52 · Reduced service | $891.25 | $1,122.02 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $457.09 Typical High $537.03 | Professional | 53 · Discontinued | $354.81 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $338.84 Typical High $407.38 | Professional | 55 · Aftercare only | $269.15 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $229.09 Typical High $269.15 | Professional | 56 · Pre-op care only | $177.83 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,584.89 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,584.89 | $1,905.46 |
Where New Mexico sits
The same service costs 5.5 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· 22nd of 51
$2,692
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.