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 $3,981.07 Median $6,309.57 Typical High $6,309.57 | Professional | None | $3,981.07 | $6,309.57 | $6,309.57 |
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 $3,981.07 Median $5,128.61 Typical High $6,918.31 | Professional | None | $3,981.07 | $5,128.61 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,230.27 Typical High $6,165.95 | Professional | None | $33.11 | $1,230.27 | $6,165.95 |
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 $4,265.80 Median $5,128.61 Typical High $7,079.46 | Professional | None | $4,265.80 | $5,128.61 | $7,079.46 |
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 $4,073.80 Median $5,754.40 Typical High $8,317.64 | Professional | None | $4,073.80 | $5,754.40 | $8,317.64 |
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 $1,995.26 Median $3,162.28 Typical High $3,162.28 | Professional | 52 · Reduced service | $1,995.26 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 53 · Discontinued | $794.33 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $3,019.95 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $602.56 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $630.96 Typical High $630.96 | Professional | 56 · Pre-op care only | $398.11 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $4,466.84 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $2,818.38 | $4,466.84 | $4,466.84 |
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· 22nd of 51
$5,248
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.