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 $3,715.35 Median $5,888.44 Typical High $5,888.44 | Professional | None | $3,715.35 | $5,888.44 | $5,888.44 |
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 $3,715.35 Median $4,677.35 Typical High $6,456.54 | Professional | None | $3,715.35 | $4,677.35 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,148.15 Typical High $5,754.40 | Professional | None | $33.11 | $1,148.15 | $5,754.40 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $251,188.64 | Facility | None | $602.56 | $5,370.32 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $3,981.07 Median $4,786.30 Typical High $6,606.93 | Professional | None | $3,981.07 | $4,786.30 | $6,606.93 |
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 $3,890.45 Median $5,370.32 Typical High $7,413.10 | Professional | None | $3,890.45 | $5,370.32 | $7,413.10 |
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 $1,862.09 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $1,862.09 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $741.31 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $2,754.23 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $549.54 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $371.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $2,570.40 | $4,073.80 | $4,073.80 |
Where New Mexico sits
The same service costs 21.9 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· 21st of 51
$4,898
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.