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 $1,905.46 Median $2,951.21 Typical High $2,951.21 | Professional | None | $1,905.46 | $2,951.21 | $2,951.21 |
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 $1,862.09 Median $2,398.83 Typical High $3,235.94 | Professional | None | $1,862.09 | $2,398.83 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $575.44 Typical High $2,884.03 | Professional | None | $33.11 | $575.44 | $2,884.03 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $251,188.64 | Facility | None | $602.56 | $2,511.89 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,311.31 | Professional | None | $1,949.84 | $2,398.83 | $3,311.31 |
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 $1,905.46 Median $2,754.23 Typical High $3,801.89 | Professional | None | $1,905.46 | $2,754.23 | $3,801.89 |
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 $954.99 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $954.99 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $380.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,412.54 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $281.84 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $190.55 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,318.26 | $2,089.30 | $2,089.30 |
Where New Mexico sits
The same service costs 5.0 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· 25th of 51
$2,455
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.