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 $457.09 Median $1,000.00 Typical High $7,762.47 | Facility | None | $457.09 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $645.65 | Professional | None | $407.38 | $645.65 | $645.65 |
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 $436.52 Median $537.03 Typical High $741.31 | Professional | None | $436.52 | $537.03 | $741.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $125.89 Typical High $630.96 | Professional | None | $33.11 | $125.89 | $630.96 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $707.95 Typical High $251,188.64 | Facility | None | $537.03 | $707.95 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $758.58 | Professional | None | $489.78 | $549.54 | $758.58 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,023.29 Typical High $4,365.16 | Facility | None | $575.44 | $1,023.29 | $4,365.16 |
United Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $851.14 | Professional | None | $446.68 | $616.60 | $851.14 |
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 $204.17 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $204.17 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $81.28 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $309.03 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $61.66 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $40.74 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $288.40 | $446.68 | $446.68 |
Where New Mexico sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$603
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.