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 $954.99 Median $1,348.96 Typical High $1,348.96 | Professional | None | $954.99 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,630.27 | Facility | None | $602.56 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,737.80 | Professional | None | $977.24 | $1,202.26 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $302.00 Typical High $1,513.56 | Professional | None | $33.11 | $302.00 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $2,754.23 | Facility | None | $602.56 | $1,513.56 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,905.46 | Professional | None | $977.24 | $1,202.26 | $1,905.46 |
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 $912.01 Median $1,412.54 Typical High $1,905.46 | Professional | None | $912.01 | $1,412.54 | $1,905.46 |
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 $478.63 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $478.63 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $190.55 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $707.95 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $141.25 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $95.50 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $660.69 | $954.99 | $954.99 |
Where New Mexico sits
The same service costs 18.2 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
$1,349
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.