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 $165.96 Median $1,047.13 Typical High $7,762.47 | Facility | None | $165.96 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $309.03 | Professional | None | $162.18 | $223.87 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $1,288.25 | Facility | None | $537.03 | $870.96 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $323.59 | Professional | None | $173.78 | $234.42 | $323.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $181.97 Typical High $302.00 | Professional | None | $33.11 | $181.97 | $302.00 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $851.14 Typical High $1,318.26 | Facility | None | $158.49 | $851.14 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $346.74 | Professional | None | $173.78 | $234.42 | $346.74 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $363.08 | Professional | None | $173.78 | $245.47 | $363.08 |
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 $81.28 Median $112.20 Typical High $151.36 | Professional | 52 · Reduced service | $81.28 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $44.67 Typical High $61.66 | Professional | 53 · Discontinued | $32.36 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $165.96 Typical High $229.09 | Professional | 54 · Surgery only | $120.23 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $45.71 | Professional | 55 · Aftercare only | $23.99 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.39 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.22 | $22.39 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $154.88 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $112.20 | $154.88 | $213.80 |
Where New Mexico sits
The same service costs 4.2 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· 27th of 51
$234
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.