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 $489.78 Median $1,047.13 Typical High $7,762.47 | Facility | None | $489.78 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $645.65 | Professional | None | $446.68 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,698.24 Typical High $2,398.83 | Facility | None | $537.03 | $1,698.24 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $691.83 | Professional | None | $426.58 | $501.19 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $125.89 Typical High $630.96 | Professional | None | $33.11 | $125.89 | $630.96 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $1,288.25 Typical High $2,511.89 | Facility | None | $263.03 | $1,288.25 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $741.31 | Professional | None | $426.58 | $512.86 | $741.31 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $5,011.87 | Facility | None | $575.44 | $1,174.90 | $5,011.87 |
United Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $851.14 | Professional | None | $457.09 | $630.96 | $851.14 |
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 $223.87 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $223.87 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $89.13 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $331.13 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $66.07 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $44.67 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $309.03 | $446.68 | $446.68 |
Where New Mexico sits
The same service costs 6.2 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· 25th of 51
$562
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.