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 $1,445.44 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,445.44 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,288.25 | $2,041.74 | $2,041.74 |
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 $1,348.96 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,348.96 | $1,659.59 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $398.11 Typical High $1,995.26 | Professional | None | $33.11 | $398.11 | $1,995.26 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $251,188.64 | Facility | None | $602.56 | $1,862.09 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,479.11 | $1,698.24 | $2,290.87 |
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 $1,348.96 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,949.84 | $2,630.27 |
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 $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $645.65 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $257.04 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $977.24 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $194.98 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $128.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $912.01 | $1,412.54 | $1,412.54 |
Where New Mexico sits
The same service costs 5.4 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
$1,820
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.