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 $1,000.00 Median $2,041.74 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,888.44 Typical High $8,317.64 | Facility | None | $602.56 | $5,888.44 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,548.82 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $371.54 Typical High $1,862.09 | Professional | None | $33.11 | $371.54 | $1,862.09 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $8,511.38 | Facility | None | $602.56 | $1,737.80 | $8,511.38 |
Providence Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,380.38 | $1,584.89 | $2,137.96 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $10,232.93 Typical High $23,988.33 | Facility | None | $3,981.07 | $10,232.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,258.93 | $1,778.28 | $2,454.71 |
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 $602.56 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $602.56 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $239.88 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $891.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $177.83 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $120.23 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $831.76 | $1,318.26 | $1,318.26 |
Where New Mexico sits
The same service costs 25.7 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
$1,738
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.