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 $446.68 Median $1,380.38 Typical High $7,762.47 | Facility | None | $446.68 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $616.60 | Professional | None | $426.58 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,288.25 Typical High $1,548.82 | Facility | None | $776.25 | $1,288.25 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $776.25 | Professional | None | $446.68 | $537.03 | $776.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $128.82 Typical High $645.65 | Professional | None | $33.11 | $128.82 | $645.65 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $1,230.27 Typical High $1,905.46 | Facility | None | $407.38 | $1,230.27 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $851.14 | Professional | None | $446.68 | $537.03 | $851.14 |
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 $407.38 Median $645.65 Typical High $851.14 | Professional | None | $407.38 | $645.65 | $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 $213.80 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $213.80 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $87.10 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $323.59 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $64.57 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $42.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $302.00 | $426.58 | $426.58 |
Where New Mexico sits
The same service costs 5.8 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· 24th of 51
$646
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.