How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $7,762.47 | Facility | None | $1,000.00 | $2,089.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $4,168.69 Median $6,760.83 Typical High $6,760.83 | Professional | None | $4,168.69 | $6,760.83 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $707.95 | Facility | None | $537.03 | $602.56 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $4,570.88 Median $5,495.41 Typical High $7,585.78 | Professional | None | $4,570.88 | $5,495.41 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,318.26 Typical High $6,606.93 | Professional | None | $33.11 | $1,318.26 | $6,606.93 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $6,025.60 Typical High $251,188.64 | Facility | None | $602.56 | $6,025.60 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $5,011.87 Median $5,754.40 Typical High $7,943.28 | Professional | None | $5,011.87 | $5,754.40 | $7,943.28 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,412.54 Typical High $10,471.29 | Facility | None | $407.38 | $1,412.54 | $10,471.29 |
United Setting Professional Modifier None Typical Low $4,365.16 Median $6,456.54 Typical High $8,709.64 | Professional | None | $4,365.16 | $6,456.54 | $8,709.64 |
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 $2,089.30 Median $3,311.31 Typical High $3,311.31 | Professional | 52 · Reduced service | $2,089.30 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $1,348.96 Typical High $1,348.96 | Professional | 53 · Discontinued | $831.76 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $5,011.87 Typical High $5,011.87 | Professional | 54 · Surgery only | $3,162.28 | $5,011.87 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $1,000.00 Typical High $1,000.00 | Professional | 55 · Aftercare only | $630.96 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $676.08 Typical High $676.08 | Professional | 56 · Pre-op care only | $416.87 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $4,677.35 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $2,951.21 | $4,677.35 | $4,677.35 |
Where New Mexico sits
The same service costs 21.9 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· 20th of 51
$6,026
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.