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 $8,317.64 | Facility | None | $1,000.00 | $2,089.30 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,513.56 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,964.78 Typical High $15,488.17 | Facility | None | $602.56 | $10,964.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,621.81 | $1,949.84 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $478.63 Typical High $2,398.83 | Professional | None | $33.11 | $478.63 | $2,398.83 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,344.23 Typical High $15,848.93 | Facility | None | $602.56 | $2,344.23 | $15,848.93 |
Providence Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,621.81 | $1,949.84 | $3,090.30 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $10,232.93 Typical High $25,118.86 | Facility | None | $3,981.07 | $10,232.93 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,479.11 | $2,290.87 | $3,019.95 |
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 $758.58 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $758.58 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $302.00 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,148.15 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $229.09 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $151.36 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,513.56 | $1,513.56 |
Where New Mexico sits
The same service costs 17.0 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
$2,188
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.