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 $102.33 Median $1,380.38 Typical High $7,762.47 | Facility | None | $102.33 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $165.96 | Professional | None | $102.33 | $125.89 | $165.96 |
BCBS New Mexico Setting Facility Modifier None Typical Low $436.52 Median $1,584.89 Typical High $2,454.71 | Facility | None | $436.52 | $1,584.89 | $2,454.71 |
BCBS New Mexico Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $173.78 | Professional | None | $69.18 | $125.89 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $158.49 Typical High $1,202.26 | Facility | None | $120.23 | $158.49 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $229.09 | Professional | None | $109.65 | $169.82 | $229.09 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $120.23 Typical High $199.53 | Professional | None | $23.99 | $120.23 | $199.53 |
Providence Setting Facility Modifier None Typical Low $120.23 Median $177.83 Typical High $1,288.25 | Facility | None | $120.23 | $177.83 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $229.09 | Professional | None | $114.82 | $173.78 | $229.09 |
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 $104.71 Median $162.18 Typical High $239.88 | Professional | None | $104.71 | $162.18 | $239.88 |
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 $60.26 Typical High $83.18 | Professional | 52 · Reduced service | $51.29 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $23.99 Typical High $33.11 | Professional | 53 · Discontinued | $20.42 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $91.20 Typical High $123.03 | Professional | 54 · Surgery only | $77.62 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $18.20 Typical High $24.55 | Professional | 55 · Aftercare only | $15.49 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.02 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.23 | $12.02 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $85.11 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $72.44 | $85.11 | $114.82 |
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
$162
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.