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 $1,000.00 Median $1,348.96 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,348.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,905.46 | $1,905.46 |
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 $1,288.25 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,548.82 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $380.19 Typical High $1,905.46 | Professional | None | $33.11 | $380.19 | $1,905.46 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $251,188.64 | Facility | None | $602.56 | $1,737.80 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,584.89 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,466.84 Typical High $12,022.64 | Facility | None | $1,348.96 | $4,466.84 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,819.70 | $2,511.89 |
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 $616.60 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $616.60 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $245.47 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $912.01 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $181.97 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $123.03 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $851.14 | $1,348.96 | $1,348.96 |
Where New Mexico sits
The same service costs 26.3 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
$1,738
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.