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 $1,548.82 Typical High $8,709.64 | Facility | None | $1,000.00 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $1,318.26 | Professional | None | $933.25 | $1,318.26 | $1,318.26 |
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 $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 $33.11 Median $295.12 Typical High $1,479.11 | Professional | None | $33.11 | $295.12 | $1,479.11 |
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 $1,023.29 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,230.27 | $1,905.46 |
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 $954.99 Median $1,445.44 Typical High $1,862.09 | Professional | None | $954.99 | $1,445.44 | $1,862.09 |
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 $467.74 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $467.74 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $186.21 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $691.83 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $93.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $645.65 | $933.25 | $933.25 |
Where New Mexico sits
The same service costs 8.3 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
$1,413
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.