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 $2,041.74 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,819.70 | $1,819.70 |
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 $1,380.38 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,659.59 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $407.38 Typical High $2,041.74 | Professional | None | $33.11 | $407.38 | $2,041.74 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $6,456.54 | Facility | None | $602.56 | $2,041.74 | $6,456.54 |
Providence Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,659.59 | $2,570.40 |
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 $1,258.93 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,949.84 | $2,570.40 |
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 $660.69 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $660.69 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $263.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $977.24 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $199.53 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $131.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $912.01 | $1,288.25 | $1,288.25 |
Where New Mexico sits
The same service costs 19.5 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
$1,862
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.