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 $389.05 Median $1,548.82 Typical High $8,709.64 | Facility | None | $389.05 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $501.19 | Professional | None | $363.08 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $691.83 | Professional | None | $371.54 | $478.63 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $112.20 Typical High $562.34 | Professional | None | $33.11 | $112.20 | $562.34 |
Providence Setting Facility Modifier None Typical Low $501.19 Median $2,238.72 Typical High $6,165.95 | Facility | None | $501.19 | $2,238.72 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $707.95 | Professional | None | $371.54 | $489.78 | $707.95 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $707.95 | Professional | None | $338.84 | $537.03 | $707.95 |
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 $181.97 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $181.97 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $72.44 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $275.42 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $54.95 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $36.31 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $257.04 | $346.74 | $346.74 |
Where New Mexico sits
The same service costs 7.2 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
$537
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.