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 $501.19 Median $1,000.00 Typical High $7,762.47 | Facility | None | $501.19 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $831.76 | Professional | None | $501.19 | $630.96 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $3,311.31 | Facility | None | $776.25 | $1,905.46 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,023.29 | Professional | None | $549.54 | $741.31 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $562.34 Typical High $933.25 | Professional | None | $33.11 | $562.34 | $933.25 |
Providence Setting Facility Modifier None Typical Low $575.44 Median $1,905.46 Typical High $3,311.31 | Facility | None | $575.44 | $1,905.46 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,096.48 | Professional | None | $549.54 | $741.31 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,148.15 | Professional | None | $549.54 | $794.33 | $1,148.15 |
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 $251.19 Median $316.23 Typical High $416.87 | Professional | 52 · Reduced service | $251.19 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $125.89 Typical High $165.96 | Professional | 53 · Discontinued | $100.00 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $467.74 Typical High $630.96 | Professional | 54 · Surgery only | $371.54 | $467.74 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $95.50 Typical High $125.89 | Professional | 55 · Aftercare only | $75.86 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $63.10 Typical High $83.18 | Professional | 56 · Pre-op care only | $50.12 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $436.52 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $346.74 | $436.52 | $588.84 |
Where New Mexico sits
The same service costs 5.8 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· 31st of 51
$741
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.