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 $660.69 Median $1,548.82 Typical High $8,709.64 | Facility | None | $660.69 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $912.01 | Professional | None | $588.84 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,691.53 | Facility | None | $602.56 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,000.00 | Professional | None | $602.56 | $758.58 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $181.97 Typical High $912.01 | Professional | None | $33.11 | $181.97 | $912.01 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,698.24 Typical High $2,691.53 | Facility | None | $537.03 | $1,698.24 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,071.52 | Professional | None | $630.96 | $758.58 | $1,071.52 |
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 $602.56 Median $870.96 Typical High $1,202.26 | Professional | None | $602.56 | $870.96 | $1,202.26 |
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 $295.12 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $295.12 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $120.23 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $446.68 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $89.13 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $58.88 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $416.87 | $645.65 | $645.65 |
Where New Mexico sits
The same service costs 5.6 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
$813
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.