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 $758.58 Median $2,089.30 Typical High $8,912.51 | Facility | None | $758.58 | $2,089.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $954.99 | Professional | None | $676.08 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,047.13 | $3,467.37 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,230.27 | Professional | None | $707.95 | $831.76 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $213.80 Typical High $1,071.52 | Professional | None | $33.11 | $213.80 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $6,165.95 | Facility | None | $741.31 | $3,467.37 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,318.26 | Professional | None | $707.95 | $851.14 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,348.96 | Professional | None | $645.65 | $1,000.00 | $1,348.96 |
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 $338.84 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $338.84 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $134.90 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $501.19 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $102.33 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $67.61 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $467.74 | $676.08 | $676.08 |
Where New Mexico sits
The same service costs 8.5 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· 25th of 51
$1,000
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.