How much rates vary
Facilitymedian $427 · 10th to 90th $166 to $1,000Professionalmedian $363 · 10th to 90th $224 to $501
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $281.84 Median $1,000.00 Typical High $7,762.47 | Facility | None | $281.84 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $416.87 | Professional | None | $275.42 | $363.08 | $416.87 |
BCBS New Mexico Setting Facility Modifier None Typical Low $165.96 Median $602.56 Typical High $933.25 | Facility | None | $165.96 | $602.56 | $933.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $165.96 Median $346.74 Typical High $524.81 | Professional | None | $165.96 | $346.74 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $602.56 | Facility | None | $158.49 | $190.55 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $501.19 | Professional | None | $281.84 | $371.54 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $281.84 Typical High $467.74 | Professional | None | $33.11 | $281.84 | $467.74 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $537.03 | Facility | None | $162.18 | $263.03 | $537.03 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $537.03 | Professional | None | $288.40 | $380.19 | $537.03 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $549.54 | Professional | None | $263.03 | $398.11 | $549.54 |
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 $141.25 Median $177.83 Typical High $208.93 | Professional | 52 · Reduced service | $141.25 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $72.44 Typical High $83.18 | Professional | 53 · Discontinued | $56.23 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $269.15 Typical High $309.03 | Professional | 54 · Surgery only | $213.80 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $53.70 Typical High $61.66 | Professional | 55 · Aftercare only | $42.66 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.18 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $251.19 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $199.53 | $251.19 | $288.40 |
Where New Mexico sits
The same service costs 6.7 times more in New York than in Florida. 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.
Physician feeFacility fee
NY $2,828FL $419
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.