How much rates vary
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 $645.65 Median $1,548.82 Typical High $8,709.64 | Facility | None | $645.65 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $831.76 | Professional | None | $588.84 | $831.76 | $831.76 |
BCBS Setting Facility Modifier None Typical Low $616.60 Median $2,570.40 Typical High $14,454.40 | Facility | None | $616.60 | $2,570.40 | $14,454.40 |
BCBS Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,174.90 | Professional | None | $575.44 | $776.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,071.52 | Professional | None | $616.60 | $741.31 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $186.21 Typical High $933.25 | Professional | None | $33.11 | $186.21 | $933.25 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,754.23 | Facility | None | $602.56 | $1,905.46 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,174.90 | Professional | None | $616.60 | $741.31 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,235.94 | $10,471.29 |
United Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $1,148.15 | Professional | None | $562.34 | $870.96 | $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 $295.12 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $295.12 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $117.49 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $436.52 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $87.10 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $58.88 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $407.38 | $575.44 | $575.44 |
Where New Mexico sits
The same service costs 7.4 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· 24th 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.