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 $724.44 Median $1,000.00 Typical High $7,762.47 | Facility | None | $724.44 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,230.27 | Professional | None | $691.83 | $977.24 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,467.37 Typical High $4,897.79 | Facility | None | $776.25 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,288.25 | Professional | None | $724.44 | $954.99 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $741.31 Typical High $1,230.27 | Professional | None | $33.11 | $741.31 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,754.23 Typical High $5,128.61 | Facility | None | $660.69 | $2,754.23 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,348.96 | Professional | None | $758.58 | $977.24 | $1,348.96 |
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 $741.31 Median $1,047.13 Typical High $1,445.44 | Professional | None | $741.31 | $1,047.13 | $1,445.44 |
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 $346.74 Median $489.78 Typical High $616.60 | Professional | 52 · Reduced service | $346.74 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $194.98 Typical High $245.47 | Professional | 53 · Discontinued | $138.04 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $724.44 Typical High $933.25 | Professional | 54 · Surgery only | $512.86 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $144.54 Typical High $186.21 | Professional | 55 · Aftercare only | $102.33 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $97.72 Typical High $123.03 | Professional | 56 · Pre-op care only | $69.18 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $676.08 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $478.63 | $676.08 | $870.96 |
Where New Mexico sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$977
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.