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 $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 $977.24 Median $1,513.56 Typical High $1,513.56 | Professional | None | $977.24 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,288.25 Typical High $1,905.46 | Facility | None | $776.25 | $1,288.25 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,698.24 | Professional | None | $912.01 | $1,202.26 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $331.13 Typical High $1,659.59 | Professional | None | $33.11 | $331.13 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,230.27 Typical High $2,754.23 | Facility | None | $776.25 | $1,230.27 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,778.28 | Professional | None | $912.01 | $1,230.27 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $1,995.26 | Professional | None | $870.96 | $1,380.38 | $1,995.26 |
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 $478.63 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $478.63 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $194.98 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $724.44 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $144.54 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $97.72 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $676.08 | $1,071.52 | $1,071.52 |
Where New Mexico sits
The same service costs 5.9 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· 29th of 51
$1,288
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.