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 $1,548.82 Typical High $8,709.64 | Facility | None | $870.96 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,096.48 | Professional | None | $758.58 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,318.26 | Professional | None | $776.25 | $954.99 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $239.88 Typical High $1,202.26 | Professional | None | $33.11 | $239.88 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,754.23 | Facility | None | $602.56 | $1,905.46 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,445.44 | Professional | None | $776.25 | $954.99 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,235.94 | $10,471.29 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,479.11 | Professional | None | $724.44 | $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 $380.19 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $380.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $154.88 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $575.44 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $114.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $75.86 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $537.03 | $776.25 | $776.25 |
Where New Mexico sits
The same service costs 7.4 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.