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 $1,380.38 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,230.27 | $1,949.84 | $1,949.84 |
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 $1,318.26 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,584.89 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $380.19 Typical High $1,905.46 | Professional | None | $33.11 | $380.19 | $1,905.46 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $251,188.64 | Facility | None | $602.56 | $1,819.70 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,659.59 | $2,238.72 |
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 $1,318.26 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,862.09 | $2,570.40 |
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 $616.60 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $616.60 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $251.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $933.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $186.21 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $123.03 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $870.96 | $1,380.38 | $1,380.38 |
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
$1,778
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.