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 $537.03 Median $1,380.38 Typical High $7,762.47 | Facility | None | $537.03 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | None | $537.03 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $2,630.27 | Facility | None | $776.25 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,023.29 | Professional | None | $575.44 | $691.83 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $154.88 Typical High $776.25 | Professional | None | $33.11 | $154.88 | $776.25 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,513.56 Typical High $2,754.23 | Facility | None | $776.25 | $1,513.56 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,023.29 | Professional | None | $575.44 | $691.83 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $15,848.93 | Facility | None | $1,995.26 | $5,495.41 | $15,848.93 |
United Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,071.52 | Professional | None | $549.54 | $794.33 | $1,071.52 |
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 $269.15 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $371.54 | $478.63 | $478.63 |
Where New Mexico sits
The same service costs 6.6 times more in Alaska than in Utah. 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· 28th of 51
$776
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.