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 $1,548.82 Typical High $8,709.64 | Facility | None | $1,000.00 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,754.40 Typical High $7,943.28 | Facility | None | $602.56 | $5,754.40 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,513.56 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $389.05 Typical High $1,949.84 | Professional | None | $33.11 | $389.05 | $1,949.84 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,238.72 Typical High $8,317.64 | Facility | None | $602.56 | $2,238.72 | $8,317.64 |
Providence Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,548.82 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,348.96 | $4,786.30 | $14,125.38 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,737.80 Typical High $2,344.23 | Professional | None | $794.33 | $1,737.80 | $2,344.23 |
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 $616.60 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $616.60 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $245.47 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $912.01 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $181.97 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $123.03 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $851.14 | $1,230.27 | $1,230.27 |
Where New Mexico sits
The same service costs 8.9 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· 24th of 51
$1,778
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.