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 $208.93 Median $1,548.82 Typical High $8,709.64 | Facility | None | $208.93 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $478.63 | Professional | None | $208.93 | $309.03 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $389.05 Typical High $602.56 | Facility | None | $275.42 | $389.05 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $354.81 Typical High $524.81 | Professional | None | $208.93 | $354.81 | $524.81 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $85.11 Typical High $416.87 | Professional | None | $33.11 | $85.11 | $416.87 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $426.58 Typical High $602.56 | Facility | None | $275.42 | $426.58 | $602.56 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $354.81 Typical High $524.81 | Professional | None | $218.78 | $354.81 | $524.81 |
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 $239.88 Median $354.81 Typical High $524.81 | Professional | None | $239.88 | $354.81 | $524.81 |
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 $104.71 Median $154.88 Typical High $239.88 | Professional | 52 · Reduced service | $104.71 | $154.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $61.66 Typical High $95.50 | Professional | 53 · Discontinued | $41.69 | $61.66 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $229.09 Typical High $363.08 | Professional | 54 · Surgery only | $154.88 | $229.09 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $45.71 Typical High $72.44 | Professional | 55 · Aftercare only | $31.62 | $45.71 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.90 Typical High $47.86 | Professional | 56 · Pre-op care only | $20.89 | $30.90 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $213.80 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $144.54 | $213.80 | $338.84 |
Where New Mexico sits
The same service costs 4.2 times more in Wyoming 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· 22nd of 51
$355
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.