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 $123.03 Median $467.74 Typical High $2,137.96 | Facility | None | $123.03 | $467.74 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $295.12 | Professional | None | $102.33 | $181.97 | $295.12 |
BCBS New Mexico Setting Facility Modifier None Typical Low $147.91 Median $524.81 Typical High $812.83 | Facility | None | $147.91 | $524.81 | $812.83 |
BCBS New Mexico Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $288.40 | Professional | None | $89.13 | $147.91 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $602.56 | Facility | None | $257.04 | $309.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $407.38 | Professional | None | $114.82 | $186.21 | $407.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $100.00 Typical High $346.74 | Professional | None | $33.11 | $100.00 | $346.74 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $295.12 Typical High $537.03 | Facility | None | $165.96 | $295.12 | $537.03 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $407.38 | Professional | None | $128.82 | $186.21 | $407.38 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $2,630.27 | Facility | None | $346.74 | $707.95 | $2,630.27 |
United Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $354.81 | Professional | None | $102.33 | $177.83 | $354.81 |
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 $51.29 Median $61.66 Typical High $147.91 | Professional | 52 · Reduced service | $51.29 | $61.66 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $24.55 Typical High $58.88 | Professional | 53 · Discontinued | $20.42 | $24.55 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $91.20 Typical High $218.78 | Professional | 54 · Surgery only | $75.86 | $91.20 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.20 Typical High $44.67 | Professional | 55 · Aftercare only | $15.14 | $18.20 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.30 Typical High $29.51 | Professional | 56 · Pre-op care only | $10.23 | $12.30 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $85.11 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $70.79 | $85.11 | $204.17 |
Where New Mexico sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 37th of 51
$191
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.