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 $501.19 Median $1,000.00 Typical High $7,762.47 | Facility | None | $501.19 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $676.08 | Professional | None | $446.68 | $676.08 | $676.08 |
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 $512.86 Median $707.95 Typical High $831.76 | Professional | None | $512.86 | $707.95 | $831.76 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $549.54 Typical High $575.44 | Professional | None | $109.65 | $549.54 | $575.44 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $125,892.54 Typical High $251,188.64 | Facility | None | $602.56 | $125,892.54 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $794.33 | Professional | None | $537.03 | $707.95 | $794.33 |
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 $489.78 Median $676.08 Typical High $912.01 | Professional | None | $489.78 | $676.08 | $912.01 |
4 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 54 · Surgery only Typical Low $338.84 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $338.84 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $67.61 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $44.67 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $316.23 | $478.63 | $478.63 |
Where New Mexico sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 28th of 51
$617
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.