How much rates vary
Facilitymedian $363 · 10th to 90th $126 to $1,000Professionalmedian $126 · 10th to 90th $76 to $182
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $95.50 Median $1,047.13 Typical High $7,762.47 | Facility | None | $95.50 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $158.49 | Professional | None | $91.20 | $120.23 | $158.49 |
BCBS New Mexico Setting Facility Modifier None Typical Low $165.96 Median $602.56 Typical High $933.25 | Facility | None | $165.96 | $602.56 | $933.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $57.54 Median $114.82 Typical High $177.83 | Professional | None | $57.54 | $114.82 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $138.04 Typical High $602.56 | Facility | None | $114.82 | $138.04 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $181.97 | Professional | None | $97.72 | $131.83 | $181.97 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $109.65 Typical High $181.97 | Professional | None | $21.88 | $109.65 | $181.97 |
Providence Setting Facility Modifier None Typical Low $114.82 Median $144.54 Typical High $537.03 | Facility | None | $114.82 | $144.54 | $537.03 |
Providence Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $190.55 | Professional | None | $97.72 | $131.83 | $190.55 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $204.17 | Professional | None | $93.33 | $134.90 | $204.17 |
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 $46.77 Median $60.26 Typical High $79.43 | Professional | 52 · Reduced service | $46.77 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $23.99 Typical High $31.62 | Professional | 53 · Discontinued | $19.05 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $91.20 Typical High $117.49 | Professional | 54 · Surgery only | $70.79 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.20 Typical High $23.44 | Professional | 55 · Aftercare only | $14.13 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.02 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.33 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $85.11 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $66.07 | $85.11 | $109.65 |
Where New Mexico sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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.
Physician feeFacility fee
HI $2,944MD $224
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.