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 $190.55 Median $1,047.13 Typical High $7,762.47 | Facility | None | $190.55 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $371.54 | Professional | None | $181.97 | $257.04 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $1,202.26 | Facility | None | $338.84 | $407.38 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $389.05 | Professional | None | $199.53 | $281.84 | $389.05 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $218.78 Typical High $363.08 | Professional | None | $33.11 | $218.78 | $363.08 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $398.11 Typical High $1,288.25 | Facility | None | $186.21 | $398.11 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $398.11 | Professional | None | $199.53 | $281.84 | $398.11 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $426.58 | Professional | None | $199.53 | $288.40 | $426.58 |
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 $93.33 Median $128.82 Typical High $186.21 | Professional | 52 · Reduced service | $93.33 | $128.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $51.29 Typical High $74.13 | Professional | 53 · Discontinued | $37.15 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $190.55 Typical High $281.84 | Professional | 54 · Surgery only | $138.04 | $190.55 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.02 Typical High $56.23 | Professional | 55 · Aftercare only | $27.54 | $38.02 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $25.70 Typical High $37.15 | Professional | 56 · Pre-op care only | $18.62 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $177.83 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $128.82 | $177.83 | $263.03 |
Where New Mexico sits
The same service costs 4.2 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· 26th of 51
$282
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.