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 $851.14 Median $2,041.74 Typical High $7,762.47 | Facility | None | $851.14 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,096.48 | Professional | None | $758.58 | $1,096.48 | $1,096.48 |
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 $794.33 Median $954.99 Typical High $1,380.38 | Professional | None | $794.33 | $954.99 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $239.88 Typical High $1,202.26 | Professional | None | $33.11 | $239.88 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $2,754.23 Typical High $6,165.95 | Facility | None | $776.25 | $2,754.23 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,513.56 | Professional | None | $794.33 | $954.99 | $1,513.56 |
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 $741.31 Median $1,122.02 Typical High $1,513.56 | Professional | None | $741.31 | $1,122.02 | $1,513.56 |
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 $380.19 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $380.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $154.88 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $575.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $75.86 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $537.03 | $758.58 | $758.58 |
Where New Mexico sits
The same service costs 7.6 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
$1,122
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.