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 $151.36 Median $1,047.13 Typical High $7,762.47 | Facility | None | $151.36 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $239.88 | Professional | None | $151.36 | $186.21 | $239.88 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,778.28 Median $6,309.57 Typical High $9,772.37 | Facility | None | $1,778.28 | $6,309.57 | $9,772.37 |
BCBS New Mexico Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $257.04 | Professional | None | $104.71 | $186.21 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $186.21 Typical High $1,202.26 | Facility | None | $154.88 | $186.21 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $331.13 | Professional | None | $165.96 | $251.19 | $331.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $173.78 Typical High $288.40 | Professional | None | $33.11 | $173.78 | $288.40 |
Providence Setting Facility Modifier None Typical Low $154.88 Median $223.87 Typical High $1,288.25 | Facility | None | $154.88 | $223.87 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $331.13 | Professional | None | $173.78 | $257.04 | $331.13 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $346.74 | Professional | None | $162.18 | $251.19 | $346.74 |
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 $75.86 Median $91.20 Typical High $120.23 | Professional | 52 · Reduced service | $75.86 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $36.31 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $134.90 Typical High $177.83 | Professional | 54 · Surgery only | $112.20 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $22.39 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $18.20 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $125.89 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $104.71 | $125.89 | $165.96 |
Where New Mexico sits
The same service costs 4.0 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· 19th of 51
$240
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.