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 $1,023.29 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,511.89 Typical High $3,801.89 | Facility | None | $776.25 | $2,511.89 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,318.26 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $323.59 Typical High $1,621.81 | Professional | None | $33.11 | $323.59 | $1,621.81 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $2,511.89 Typical High $3,801.89 | Facility | None | $776.25 | $2,511.89 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,318.26 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,348.96 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,584.89 | $2,041.74 |
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 $512.86 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $512.86 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $204.17 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $776.25 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $154.88 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $102.33 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $724.44 | $1,023.29 | $1,023.29 |
Where New Mexico sits
The same service costs 19.5 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· 27th of 51
$1,585
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.