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 $2,691.53 Median $4,365.16 Typical High $4,365.16 | Professional | None | $2,691.53 | $4,365.16 | $4,365.16 |
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 $2,884.03 Median $3,548.13 Typical High $4,786.30 | Professional | None | $2,884.03 | $3,548.13 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $851.14 Typical High $4,265.80 | Professional | None | $33.11 | $851.14 | $4,265.80 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $3,981.07 Typical High $251,188.64 | Facility | None | $602.56 | $3,981.07 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $4,897.79 | Professional | None | $3,090.30 | $3,630.78 | $4,897.79 |
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 $2,818.38 Median $3,890.45 Typical High $5,248.07 | Professional | None | $2,818.38 | $3,890.45 | $5,248.07 |
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 $1,348.96 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,348.96 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $537.03 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $3,235.94 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,041.74 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | 55 · Aftercare only | $407.38 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $269.15 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $3,019.95 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,905.46 | $3,019.95 | $3,019.95 |
Where New Mexico sits
The same service costs 21.4 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· 23rd of 51
$3,715
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.