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 $2,089.30 Typical High $8,709.64 | Facility | None | $1,000.00 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,412.54 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,187.76 Typical High $3,311.31 | Facility | None | $741.31 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,698.24 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $446.68 Typical High $2,238.72 | Professional | None | $33.11 | $446.68 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $2,137.96 Typical High $3,311.31 | Facility | None | $741.31 | $2,137.96 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,479.11 | $1,778.28 | $2,754.23 |
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 $1,318.26 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,318.26 | $2,041.74 | $2,754.23 |
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 $691.83 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $691.83 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $281.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,047.13 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $208.93 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $141.25 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $977.24 | $1,412.54 | $1,412.54 |
Where New Mexico sits
The same service costs 15.8 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· 20th of 51
$1,995
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.