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 $8,709.64 | Facility | None | $1,000.00 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $4,897.79 | Facility | None | $602.56 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,548.82 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $346.74 Typical High $1,737.80 | Professional | None | $33.11 | $346.74 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $5,128.61 | Facility | None | $602.56 | $1,778.28 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,548.82 | $2,398.83 |
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 $1,122.02 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,737.80 | $2,344.23 |
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 $602.56 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $602.56 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $239.88 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $912.01 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $181.97 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $120.23 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $851.14 | $1,122.02 | $1,122.02 |
Where New Mexico sits
The same service costs 14.5 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· 29th of 51
$1,622
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.