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 $707.95 Median $1,047.13 Typical High $7,762.47 | Facility | None | $707.95 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | None | $616.60 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $2,630.27 | Facility | None | $537.03 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,023.29 | Professional | None | $616.60 | $776.25 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $190.55 Typical High $954.99 | Professional | None | $33.11 | $190.55 | $954.99 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,288.25 Typical High $2,754.23 | Facility | None | $537.03 | $1,288.25 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,122.02 | Professional | None | $616.60 | $776.25 | $1,122.02 |
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 $562.34 Median $870.96 Typical High $1,174.90 | Professional | None | $562.34 | $870.96 | $1,174.90 |
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 $309.03 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $309.03 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $123.03 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $457.09 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $91.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $61.66 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $426.58 | $616.60 | $616.60 |
Where New Mexico sits
The same service costs 7.8 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
$871
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.