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 $1,548.82 Typical High $8,709.64 | Facility | None | $1,000.00 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,786.30 Typical High $6,760.83 | Facility | None | $602.56 | $4,786.30 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,584.89 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $380.19 Typical High $1,905.46 | Professional | None | $33.11 | $380.19 | $1,905.46 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,238.72 Typical High $6,918.31 | Facility | None | $602.56 | $2,238.72 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,348.96 | $1,584.89 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $17,378.01 | Facility | None | $1,348.96 | $4,786.30 | $17,378.01 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,862.09 | $2,398.83 |
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 $616.60 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $616.60 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $245.47 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $933.25 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $186.21 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $123.03 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $870.96 | $1,258.93 | $1,258.93 |
Where New Mexico sits
The same service costs 11.0 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· 25th of 51
$1,820
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.