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 $501.19 Median $2,089.30 Typical High $8,709.64 | Facility | None | $501.19 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $630.96 | Professional | None | $501.19 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $4,897.79 | Facility | None | $741.31 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $912.01 | Professional | None | $524.81 | $645.65 | $912.01 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $141.25 Typical High $691.83 | Professional | None | $33.11 | $141.25 | $691.83 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $3,090.30 Typical High $5,128.61 | Facility | None | $537.03 | $3,090.30 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $977.24 | Professional | None | $537.03 | $645.65 | $977.24 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $977.24 | Professional | None | $489.78 | $724.44 | $977.24 |
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 $251.19 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $251.19 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $371.54 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $74.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $346.74 | $436.52 | $436.52 |
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
$692
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.