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 $1,000.00 Median $2,089.30 Typical High $8,709.64 | Facility | None | $1,000.00 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $1,412.54 | Professional | None | $933.25 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,995.26 Typical High $2,951.21 | Facility | None | $741.31 | $1,995.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,548.82 | Professional | None | $933.25 | $1,148.15 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $275.42 Typical High $1,380.38 | Professional | None | $33.11 | $275.42 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $1,949.84 Typical High $3,090.30 | Facility | None | $741.31 | $1,949.84 | $3,090.30 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,659.59 | Professional | None | $954.99 | $1,230.27 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,348.96 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,905.46 | Professional | None | $954.99 | $1,348.96 | $1,905.46 |
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 $467.74 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $467.74 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $186.21 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $691.83 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $138.04 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $93.33 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $645.65 | $977.24 | $977.24 |
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· 21st of 51
$1,318
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.