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 $2,187.76 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,187.76 | $3,311.31 | $3,311.31 |
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 $2,344.23 Median $2,818.38 Typical High $4,073.80 | Professional | None | $2,344.23 | $2,818.38 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $707.95 Typical High $3,548.13 | Professional | None | $33.11 | $707.95 | $3,548.13 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $3,235.94 Typical High $251,188.64 | Facility | None | $602.56 | $3,235.94 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,344.23 Median $2,818.38 Typical High $4,365.16 | Professional | None | $2,344.23 | $2,818.38 | $4,365.16 |
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 $2,089.30 Median $3,235.94 Typical High $4,265.80 | Professional | None | $2,089.30 | $3,235.94 | $4,265.80 |
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 $1,096.48 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,096.48 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $436.52 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,659.59 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $331.13 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $218.78 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,290.87 | $2,290.87 |
Where New Mexico sits
The same service costs 23.4 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· 19th of 51
$3,090
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.