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 $776.25 Median $1,548.82 Typical High $8,709.64 | Facility | None | $776.25 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,000.00 | Professional | None | $741.31 | $1,000.00 | $1,000.00 |
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 $776.25 Median $933.25 Typical High $1,348.96 | Professional | None | $776.25 | $933.25 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $223.87 Typical High $1,122.02 | Professional | None | $33.11 | $223.87 | $1,122.02 |
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 $776.25 Median $933.25 Typical High $1,445.44 | Professional | None | $776.25 | $933.25 | $1,445.44 |
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 $741.31 Median $1,096.48 Typical High $1,479.11 | Professional | None | $741.31 | $1,096.48 | $1,479.11 |
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 $371.54 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $371.54 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $147.91 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $549.54 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $112.20 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $74.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $512.86 | $707.95 | $707.95 |
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
$1,096
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.