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 $120.23 Median $275.42 Typical High $2,137.96 | Facility | None | $120.23 | $275.42 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $199.53 | Professional | None | $100.00 | $147.91 | $199.53 |
BCBS New Mexico Setting Facility Modifier None Typical Low $131.83 Median $467.74 Typical High $1,584.89 | Facility | None | $131.83 | $467.74 | $1,584.89 |
BCBS New Mexico Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $186.21 | Professional | None | $75.86 | $125.89 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $158.49 Typical High $602.56 | Facility | None | $131.83 | $158.49 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $245.47 | Professional | None | $104.71 | $169.82 | $245.47 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $125.89 Typical High $213.80 | Professional | None | $25.70 | $125.89 | $213.80 |
Providence Setting Facility Modifier None Typical Low $109.65 Median $181.97 Typical High $537.03 | Facility | None | $109.65 | $181.97 | $537.03 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $245.47 | Professional | None | $107.15 | $173.78 | $245.47 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $257.04 | Professional | None | $100.00 | $162.18 | $257.04 |
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 $50.12 Median $60.26 Typical High $87.10 | Professional | 52 · Reduced service | $50.12 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $23.99 Typical High $34.67 | Professional | 53 · Discontinued | $19.95 | $23.99 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $89.13 Typical High $128.82 | Professional | 54 · Surgery only | $75.86 | $89.13 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.78 Typical High $25.70 | Professional | 55 · Aftercare only | $15.14 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.02 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.00 | $12.02 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $83.18 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $70.79 | $83.18 | $120.23 |
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· 22nd of 51
$166
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.