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 $8,912.51 | Facility | None | $1,000.00 | $2,089.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $1,318.26 | Professional | None | $912.01 | $1,318.26 | $1,318.26 |
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 $954.99 Median $1,148.15 Typical High $1,659.59 | Professional | None | $954.99 | $1,148.15 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $288.40 Typical High $1,445.44 | Professional | None | $33.11 | $288.40 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $5,128.61 | Facility | None | $602.56 | $1,380.38 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,819.70 | Professional | None | $954.99 | $1,148.15 | $1,819.70 |
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 $851.14 Median $1,380.38 Typical High $1,862.09 | Professional | None | $851.14 | $1,380.38 | $1,862.09 |
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 $457.09 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $457.09 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $181.97 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $691.83 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $91.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $645.65 | $912.01 | $912.01 |
Where New Mexico sits
The same service costs 18.2 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· 26th of 51
$1,318
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.