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 $645.65 Median $2,041.74 Typical High $7,762.47 | Facility | None | $645.65 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $812.83 | Professional | None | $575.44 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $4,265.80 Typical High $6,025.60 | Facility | None | $776.25 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,047.13 | Professional | None | $602.56 | $724.44 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $181.97 Typical High $912.01 | Professional | None | $33.11 | $181.97 | $912.01 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $2,754.23 Typical High $6,165.95 | Facility | None | $630.96 | $2,754.23 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,148.15 | Professional | None | $602.56 | $724.44 | $1,148.15 |
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 $549.54 Median $851.14 Typical High $1,148.15 | Professional | None | $549.54 | $851.14 | $1,148.15 |
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 $288.40 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $288.40 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $436.52 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $87.10 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $57.54 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $407.38 | $575.44 | $575.44 |
Where New Mexico sits
The same service costs 8.3 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
$851
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.