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 $323.59 Median $1,548.82 Typical High $8,709.64 | Facility | None | $323.59 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $741.31 | Professional | None | $323.59 | $478.63 | $741.31 |
BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $10,232.93 | Facility | None | $1,819.70 | $6,606.93 | $10,232.93 |
BCBS Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $616.60 | Professional | None | $208.93 | $363.08 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $2,187.76 | Facility | None | $602.56 | $1,479.11 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $660.69 | Professional | None | $281.84 | $416.87 | $660.69 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $131.83 Typical High $660.69 | Professional | None | $33.11 | $131.83 | $660.69 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $1,412.54 Typical High $2,238.72 | Facility | None | $478.63 | $1,412.54 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $616.60 | Professional | None | $281.84 | $416.87 | $616.60 |
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 $275.42 Median $426.58 Typical High $676.08 | Professional | None | $275.42 | $426.58 | $676.08 |
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 $162.18 Median $239.88 Typical High $371.54 | Professional | 52 · Reduced service | $162.18 | $239.88 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $95.50 Typical High $147.91 | Professional | 53 · Discontinued | $64.57 | $95.50 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $363.08 Typical High $562.34 | Professional | 54 · Surgery only | $245.47 | $363.08 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $72.44 Typical High $112.20 | Professional | 55 · Aftercare only | $48.98 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $47.86 Typical High $74.13 | Professional | 56 · Pre-op care only | $32.36 | $47.86 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $338.84 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $229.09 | $338.84 | $524.81 |
Where New Mexico sits
The same service costs 5.9 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· 27th of 51
$479
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.