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 $1,479.11 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,479.11 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,348.96 | $2,137.96 | $2,137.96 |
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 $1,380.38 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,737.80 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $416.87 Typical High $2,089.30 | Professional | None | $33.11 | $416.87 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $251,188.64 | Facility | None | $602.56 | $1,949.84 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,513.56 | $1,778.28 | $2,398.83 |
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 $1,412.54 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,412.54 | $2,041.74 | $2,754.23 |
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 $676.08 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $676.08 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $269.15 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,000.00 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $199.53 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $134.90 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $933.25 | $1,479.11 | $1,479.11 |
Where New Mexico sits
The same service costs 5.2 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· 22nd of 51
$1,905
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.