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 $331.13 Median $1,548.82 Typical High $8,709.64 | Facility | None | $331.13 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $645.65 | Professional | None | $331.13 | $416.87 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $891.25 Typical High $1,698.24 | Facility | None | $602.56 | $891.25 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $724.44 | Professional | None | $338.84 | $478.63 | $724.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $426.58 Typical High $707.95 | Professional | None | $33.11 | $426.58 | $707.95 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $2,238.72 | Facility | None | $338.84 | $851.14 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $776.25 | Professional | None | $338.84 | $501.19 | $776.25 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $831.76 | Professional | None | $316.23 | $524.81 | $831.76 |
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 $165.96 Median $208.93 Typical High $323.59 | Professional | 52 · Reduced service | $165.96 | $208.93 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $128.82 | Professional | 53 · Discontinued | $66.07 | $83.18 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $478.63 | Professional | 54 · Surgery only | $251.19 | $316.23 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $95.50 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $41.69 Typical High $64.57 | Professional | 56 · Pre-op care only | $33.11 | $41.69 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $295.12 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $234.42 | $295.12 | $446.68 |
Where New Mexico sits
The same service costs 5.1 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· 31st of 51
$501
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.