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 $1,258.93 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,258.93 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,778.28 | $1,778.28 |
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 $1,148.15 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,445.44 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $346.74 Typical High $1,737.80 | Professional | None | $33.11 | $346.74 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,584.89 Typical High $251,188.64 | Facility | None | $602.56 | $1,584.89 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,479.11 | $1,995.26 |
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 $1,174.90 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,698.24 | $2,290.87 |
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 $562.34 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $562.34 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $223.87 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $851.14 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $169.82 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $112.20 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $794.33 | $1,230.27 | $1,230.27 |
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· 21st of 51
$1,585
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.