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 $575.44 Median $1,548.82 Typical High $8,709.64 | Facility | None | $575.44 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $724.44 | Professional | None | $524.81 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $954.99 | Professional | None | $537.03 | $645.65 | $954.99 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $162.18 Typical High $812.83 | Professional | None | $33.11 | $162.18 | $812.83 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,238.72 Typical High $6,165.95 | Facility | None | $602.56 | $2,238.72 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,047.13 | Professional | None | $537.03 | $645.65 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $14,125.38 | Facility | None | $1,230.27 | $3,235.94 | $14,125.38 |
United Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,023.29 | Professional | None | $501.19 | $776.25 | $1,023.29 |
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 $263.03 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $263.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $104.71 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $389.05 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $77.62 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $52.48 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $363.08 | $512.86 | $512.86 |
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· 25th of 51
$776
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.