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 $426.58 Median $1,047.13 Typical High $7,762.47 | Facility | None | $426.58 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $549.54 | Professional | None | $389.05 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $2,630.27 | Facility | None | $537.03 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $691.83 | Professional | None | $398.11 | $478.63 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $123.03 Typical High $616.60 | Professional | None | $33.11 | $123.03 | $616.60 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $1,288.25 Typical High $2,754.23 | Facility | None | $398.11 | $1,288.25 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $758.58 | Professional | None | $398.11 | $478.63 | $758.58 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $758.58 | Professional | None | $371.54 | $575.44 | $758.58 |
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 $194.98 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $194.98 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $77.62 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $295.12 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $58.88 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.90 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $275.42 | $380.19 | $380.19 |
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
$575
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.