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 $1,071.52 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,071.52 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $1,479.11 | Professional | None | $977.24 | $1,479.11 | $1,479.11 |
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 $1,000.00 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,230.27 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $288.40 Typical High $1,445.44 | Professional | None | $33.11 | $288.40 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $251,188.64 | Facility | None | $602.56 | $1,318.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,230.27 | $1,698.24 |
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 $1,000.00 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,445.44 | $1,949.84 |
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 $478.63 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $478.63 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $194.98 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $724.44 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $144.54 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $97.72 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $676.08 | $1,047.13 | $1,047.13 |
Where New Mexico sits
The same service costs 4.9 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· 23rd of 51
$1,318
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.