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 $2,041.74 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,951.21 | $2,951.21 |
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 $1,862.09 Median $2,398.83 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,398.83 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $645.65 Typical High $3,235.94 | Professional | None | $33.11 | $645.65 | $3,235.94 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,818.38 Typical High $5,128.61 | Facility | None | $602.56 | $2,818.38 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $3,630.78 | Professional | None | $1,862.09 | $2,570.40 | $3,630.78 |
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 $2,884.03 Typical High $4,168.69 | Professional | None | $1,905.46 | $2,884.03 | $4,168.69 |
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 $1,023.29 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,023.29 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $407.38 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,513.56 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $302.00 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $204.17 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,041.74 | $2,041.74 |
Where New Mexico sits
The same service costs 21.4 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· 27th of 51
$2,818
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.