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 $8,709.64 | Facility | None | $1,000.00 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,621.81 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,548.82 | $1,995.26 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $524.81 Typical High $2,630.27 | Professional | None | $33.11 | $524.81 | $2,630.27 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,137.96 Typical High $6,165.95 | Facility | None | $602.56 | $2,137.96 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,548.82 | $2,041.74 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $16,982.44 | Facility | None | $1,995.26 | $5,495.41 | $16,982.44 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $3,162.28 | Professional | None | $1,445.44 | $2,290.87 | $3,162.28 |
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 $794.33 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $794.33 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $323.59 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,202.26 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $239.88 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $162.18 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,621.81 | $1,621.81 |
Where New Mexico sits
The same service costs 11.2 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· 23rd of 51
$2,239
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.