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 $602.56 Median $1,000.00 Typical High $7,762.47 | Facility | None | $602.56 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $831.76 | Professional | None | $537.03 | $831.76 | $831.76 |
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 $575.44 Median $691.83 Typical High $912.01 | Professional | None | $575.44 | $691.83 | $912.01 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $165.96 Typical High $831.76 | Professional | None | $33.11 | $165.96 | $831.76 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $851.14 Typical High $1,318.26 | Facility | None | $537.03 | $851.14 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $954.99 | Professional | None | $602.56 | $707.95 | $954.99 |
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 $575.44 Median $794.33 Typical High $1,096.48 | Professional | None | $575.44 | $794.33 | $1,096.48 |
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 $269.15 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $269.15 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $107.15 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $407.38 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $81.28 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $53.70 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $380.19 | $588.84 | $588.84 |
Where New Mexico sits
The same service costs 5.5 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· 22nd of 51
$759
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.