How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $912.01 Median $2,089.30 Typical High $8,709.64 | Facility | None | $912.01 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,174.90 | Professional | None | $831.76 | $1,174.90 | $1,174.90 |
BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $14,454.40 Typical High $22,387.21 | Facility | None | $4,073.80 | $14,454.40 | $22,387.21 |
BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,584.89 | Professional | None | $831.76 | $1,096.48 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,025.60 Typical High $8,511.38 | Facility | None | $741.31 | $6,025.60 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,548.82 | Professional | None | $870.96 | $1,047.13 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $263.03 Typical High $1,318.26 | Professional | None | $33.11 | $263.03 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $8,709.64 | Facility | None | $741.31 | $3,090.30 | $8,709.64 |
Providence Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,659.59 | Professional | None | $870.96 | $1,047.13 | $1,659.59 |
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 $812.83 Median $1,230.27 Typical High $1,621.81 | Professional | None | $812.83 | $1,230.27 | $1,621.81 |
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 $416.87 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $416.87 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $165.96 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $616.60 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $123.03 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $83.18 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $575.44 | $831.76 | $831.76 |
Where New Mexico sits
The same service costs 7.9 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
$1,259
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.