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 $2,041.74 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,412.54 | $1,412.54 |
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 $1,023.29 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,230.27 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $691.83 Typical High $691.83 | Professional | None | $60.26 | $691.83 | $691.83 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $15,848.93 | Facility | None | $602.56 | $1,513.56 | $15,848.93 |
Providence Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,230.27 | $1,778.28 |
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 $954.99 Median $1,513.56 Typical High $2,290.87 | Professional | None | $954.99 | $1,513.56 | $2,290.87 |
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 $501.19 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $501.19 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $199.53 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $741.31 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $151.36 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $100.00 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $691.83 | $1,000.00 | $1,000.00 |
Where New Mexico sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 36th of 51
$1,413
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.