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 $2,089.30 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,089.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $7,413.10 Typical High $7,413.10 | Professional | None | $4,570.88 | $7,413.10 | $7,413.10 |
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 $4,897.79 Median $5,888.44 Typical High $8,128.31 | Professional | None | $4,897.79 | $5,888.44 | $8,128.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,445.44 Typical High $7,244.36 | Professional | None | $33.11 | $1,445.44 | $7,244.36 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $6,918.31 Typical High $251,188.64 | Facility | None | $602.56 | $6,918.31 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $5,248.07 Median $6,165.95 Typical High $8,511.38 | Professional | None | $5,248.07 | $6,165.95 | $8,511.38 |
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 $4,897.79 Median $7,079.46 Typical High $9,772.37 | Professional | None | $4,897.79 | $7,079.46 | $9,772.37 |
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 $2,290.87 Median $3,715.35 Typical High $3,715.35 | Professional | 52 · Reduced service | $2,290.87 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 53 · Discontinued | $933.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $5,495.41 Typical High $5,495.41 | Professional | 54 · Surgery only | $3,467.37 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $1,096.48 Typical High $1,096.48 | Professional | 55 · Aftercare only | $691.83 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $741.31 Typical High $741.31 | Professional | 56 · Pre-op care only | $467.74 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $5,128.61 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $3,235.94 | $5,128.61 | $5,128.61 |
Where New Mexico sits
The same service costs 20.0 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· 20th of 51
$6,607
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.