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 $977.24 Median $2,041.74 Typical High $7,762.47 | Facility | None | $977.24 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,258.93 | Professional | None | $891.25 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $4,265.80 Typical High $6,025.60 | Facility | None | $776.25 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,659.59 | Professional | None | $933.25 | $1,122.02 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $281.84 Typical High $1,412.54 | Professional | None | $33.11 | $281.84 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $2,754.23 Typical High $6,165.95 | Facility | None | $776.25 | $2,754.23 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,778.28 | Professional | None | $933.25 | $1,122.02 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,348.96 | $4,786.30 | $14,125.38 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $1,778.28 | Professional | None | $870.96 | $1,318.26 | $1,778.28 |
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 $446.68 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $446.68 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $177.83 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $660.69 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $131.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $89.13 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $616.60 | $891.25 | $891.25 |
Where New Mexico sits
The same service costs 7.9 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· 27th of 51
$1,318
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.