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 $602.56 Median $1,380.38 Typical High $7,762.47 | Facility | None | $602.56 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $851.14 | Professional | None | $549.54 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,659.59 Typical High $2,290.87 | Facility | None | $776.25 | $1,659.59 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $912.01 | Professional | None | $549.54 | $691.83 | $912.01 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $165.96 Typical High $831.76 | Professional | None | $33.11 | $165.96 | $831.76 |
Providence Setting Facility Modifier None Typical Low $457.09 Median $1,513.56 Typical High $2,398.83 | Facility | None | $457.09 | $1,513.56 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $954.99 | Professional | None | $575.44 | $691.83 | $954.99 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,096.48 | Professional | None | $549.54 | $794.33 | $1,096.48 |
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 $275.42 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $275.42 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $109.65 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $407.38 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $81.28 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $54.95 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $380.19 | $588.84 | $588.84 |
Where New Mexico sits
The same service costs 5.5 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· 24th of 51
$724
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.