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 $707.95 Median $1,047.13 Typical High $7,762.47 | Facility | None | $707.95 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $891.25 | Professional | None | $630.96 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,047.13 Typical High $1,412.54 | Facility | None | $537.03 | $1,047.13 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,148.15 | Professional | None | $660.69 | $794.33 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $199.53 Typical High $1,000.00 | Professional | None | $33.11 | $199.53 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,047.13 Typical High $1,479.11 | Facility | None | $537.03 | $1,047.13 | $1,479.11 |
Providence Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,258.93 | Professional | None | $660.69 | $794.33 | $1,258.93 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,445.44 | Facility | None | $199.53 | $275.42 | $1,445.44 |
United Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,258.93 | Professional | None | $602.56 | $933.25 | $1,258.93 |
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 $316.23 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $316.23 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $128.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $478.63 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $95.50 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $63.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $446.68 | $630.96 | $630.96 |
Where New Mexico sits
The same service costs 8.5 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
$891
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.