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 $870.96 Median $2,041.74 Typical High $7,762.47 | Facility | None | $870.96 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,122.02 | Professional | None | $794.33 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $3,311.31 | Facility | None | $776.25 | $1,905.46 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,445.44 | Professional | None | $812.83 | $977.24 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $251.19 Typical High $1,258.93 | Professional | None | $33.11 | $251.19 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $1,905.46 Typical High $3,311.31 | Facility | None | $741.31 | $1,905.46 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,548.82 | Professional | None | $812.83 | $977.24 | $1,548.82 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $5,011.87 | Facility | None | $575.44 | $1,174.90 | $5,011.87 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $1,548.82 | Professional | None | $758.58 | $1,174.90 | $1,548.82 |
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 $398.11 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $398.11 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $158.49 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $588.84 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $117.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $79.43 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $549.54 | $794.33 | $794.33 |
Where New Mexico sits
The same service costs 7.1 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
$1,122
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.