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 $676.08 Median $1,000.00 Typical High $7,762.47 | Facility | None | $676.08 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,023.29 | Professional | None | $676.08 | $831.76 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,467.37 Typical High $4,897.79 | Facility | None | $776.25 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,174.90 | Professional | None | $645.65 | $891.25 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $645.65 Typical High $1,071.52 | Professional | None | $33.11 | $645.65 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $575.44 Median $2,754.23 Typical High $5,128.61 | Facility | None | $575.44 | $2,754.23 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,258.93 | Professional | None | $645.65 | $891.25 | $1,258.93 |
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 $645.65 Median $933.25 Typical High $1,318.26 | Professional | None | $645.65 | $933.25 | $1,318.26 |
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 $338.84 Median $416.87 Typical High $512.86 | Professional | 52 · Reduced service | $338.84 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $165.96 Typical High $204.17 | Professional | 53 · Discontinued | $134.90 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $512.86 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $123.03 Typical High $151.36 | Professional | 55 · Aftercare only | $102.33 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $83.18 Typical High $102.33 | Professional | 56 · Pre-op care only | $67.61 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $575.44 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $478.63 | $575.44 | $707.95 |
Where New Mexico sits
The same service costs 6.6 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· 28th of 51
$891
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.