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 $1,258.93 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,819.70 | $1,819.70 |
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 $1,380.38 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,659.59 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $407.38 Typical High $2,041.74 | Professional | None | $33.11 | $407.38 | $2,041.74 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $7,943.28 | Facility | None | $602.56 | $1,995.26 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,659.59 | $2,570.40 |
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 $1,258.93 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,949.84 | $2,570.40 |
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 $630.96 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $630.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $257.04 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $954.99 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $190.55 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $125.89 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $891.25 | $1,288.25 | $1,288.25 |
Where New Mexico sits
The same service costs 18.6 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
$1,820
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.