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 $1,023.29 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,479.11 | $1,479.11 |
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 $1,096.48 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,318.26 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $323.59 Typical High $1,621.81 | Professional | None | $33.11 | $323.59 | $1,621.81 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,548.82 Typical High $7,943.28 | Facility | None | $602.56 | $1,548.82 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,318.26 | $2,089.30 |
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 $1,000.00 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,548.82 | $2,041.74 |
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 $512.86 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $512.86 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $204.17 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $758.58 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $154.88 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $102.33 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $707.95 | $1,023.29 | $1,023.29 |
Where New Mexico sits
The same service costs 8.7 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
$1,479
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.