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 $2,089.30 Typical High $8,709.64 | Facility | None | $1,000.00 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,380.38 | Professional | None | $977.24 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $11,220.18 Typical High $15,488.17 | Facility | None | $741.31 | $11,220.18 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,258.93 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $309.03 Typical High $1,548.82 | Professional | None | $33.11 | $309.03 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $16,218.10 | Facility | None | $741.31 | $3,090.30 | $16,218.10 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,258.93 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $19,054.61 | Facility | None | $1,348.96 | $4,786.30 | $19,054.61 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $1,949.84 | Professional | None | $954.99 | $1,445.44 | $1,949.84 |
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 $489.78 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $489.78 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $194.98 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $724.44 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $144.54 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $97.72 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $676.08 | $977.24 | $977.24 |
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· 25th of 51
$1,445
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.