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 $1,023.29 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,023.29 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,513.56 Typical High $1,513.56 | Professional | None | $954.99 | $1,513.56 | $1,513.56 |
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 $891.25 Median $1,202.26 Typical High $1,659.59 | Professional | None | $891.25 | $1,202.26 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $323.59 Typical High $1,621.81 | Professional | None | $33.11 | $323.59 | $1,621.81 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $251,188.64 | Facility | None | $602.56 | $1,258.93 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,737.80 | Professional | None | $891.25 | $1,230.27 | $1,737.80 |
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 $912.01 Median $1,230.27 Typical High $1,949.84 | Professional | None | $912.01 | $1,230.27 | $1,949.84 |
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 $190.55 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $724.44 | $1,122.02 | $1,122.02 |
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 $95.50 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $95.50 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $676.08 | $1,047.13 | $1,047.13 |
Where New Mexico sits
The same service costs 21.9 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
$1,259
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.