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 $1,698.24 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,698.24 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,479.11 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $2,630.27 | Facility | None | $776.25 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,905.46 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $478.63 Typical High $2,398.83 | Professional | None | $33.11 | $478.63 | $2,398.83 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,995.26 Typical High $2,754.23 | Facility | None | $776.25 | $1,995.26 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,584.89 | $1,905.46 | $2,951.21 |
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 $1,445.44 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,445.44 | $2,238.72 | $3,019.95 |
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 $741.31 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $741.31 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $295.12 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,122.02 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $223.87 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $147.91 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,513.56 | $1,513.56 |
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· 21st of 51
$2,188
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.