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 $2,511.89 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,511.89 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $6,165.95 | Facility | None | $602.56 | $4,466.84 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $4,570.88 | Professional | None | $2,630.27 | $3,235.94 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $812.83 Typical High $4,073.80 | Professional | None | $33.11 | $812.83 | $4,073.80 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $6,456.54 | Facility | None | $602.56 | $4,265.80 | $6,456.54 |
Providence Setting Professional Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $4,897.79 | Professional | None | $2,630.27 | $3,235.94 | $4,897.79 |
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 $2,570.40 Median $3,801.89 Typical High $5,128.61 | Professional | None | $2,570.40 | $3,801.89 | $5,128.61 |
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 $1,258.93 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,258.93 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $501.19 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,905.46 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $380.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $251.19 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,570.40 | $2,570.40 |
Where New Mexico sits
The same service costs 20.9 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· 21st 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.