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 $602.56 Median $1,548.82 Typical High $8,709.64 | Facility | None | $602.56 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $776.25 | Professional | None | $575.44 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $1,778.28 | Facility | None | $602.56 | $1,174.90 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,047.13 | Professional | None | $602.56 | $724.44 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $173.78 Typical High $870.96 | Professional | None | $33.11 | $173.78 | $870.96 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,148.15 Typical High $2,238.72 | Facility | None | $602.56 | $1,148.15 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,122.02 | Professional | None | $602.56 | $724.44 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,413.10 | Facility | None | $1,047.13 | $2,344.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,174.90 | Professional | None | $575.44 | $851.14 | $1,174.90 |
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 $288.40 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $288.40 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $114.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $436.52 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $87.10 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $57.54 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $407.38 | $549.54 | $549.54 |
Where New Mexico sits
The same service costs 7.4 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
$851
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.