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 $954.99 Median $1,000.00 Typical High $7,762.47 | Facility | None | $954.99 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,230.27 | Professional | None | $851.14 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,964.78 Typical High $15,488.17 | Facility | None | $602.56 | $10,964.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,412.54 | Professional | None | $776.25 | $1,023.29 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $269.15 Typical High $1,348.96 | Professional | None | $33.11 | $269.15 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $15,848.93 | Facility | None | $602.56 | $1,174.90 | $15,848.93 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,479.11 | Professional | None | $776.25 | $1,047.13 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $24,547.09 | Facility | None | $1,995.26 | $5,495.41 | $24,547.09 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,698.24 | Professional | None | $812.83 | $1,202.26 | $1,698.24 |
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 $426.58 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $426.58 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $169.82 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $645.65 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $128.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $85.11 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $602.56 | $851.14 | $851.14 |
Where New Mexico sits
The same service costs 16.2 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· 27th of 51
$1,175
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.