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 $1,445.44 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,445.44 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $7,585.78 | Facility | None | $602.56 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,548.82 | $1,862.09 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $457.09 Typical High $2,290.87 | Professional | None | $33.11 | $457.09 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,137.96 Typical High $7,943.28 | Facility | None | $602.56 | $2,137.96 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,862.09 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $16,982.44 | Facility | None | $1,995.26 | $5,495.41 | $16,982.44 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,412.54 | $2,187.76 | $2,884.03 |
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 $724.44 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $724.44 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $288.40 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,071.52 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $213.80 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $144.54 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,445.44 | $1,445.44 |
Where New Mexico sits
The same service costs 8.9 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· 25th of 51
$2,089
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.