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 $588.84 Median $1,548.82 Typical High $8,709.64 | Facility | None | $588.84 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $758.58 | Professional | None | $537.03 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $7,585.78 | Facility | None | $602.56 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $954.99 | Professional | None | $549.54 | $660.69 | $954.99 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $165.96 Typical High $831.76 | Professional | None | $33.11 | $165.96 | $831.76 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $2,238.72 Typical High $7,943.28 | Facility | None | $562.34 | $2,238.72 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $1,047.13 | Professional | None | $549.54 | $660.69 | $1,047.13 |
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 $512.86 Median $776.25 Typical High $1,047.13 | Professional | None | $512.86 | $776.25 | $1,047.13 |
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 $269.15 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $269.15 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $107.15 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $398.11 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $79.43 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $53.70 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $371.54 | $524.81 | $524.81 |
Where New Mexico sits
The same service costs 7.8 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· 25th of 51
$776
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.