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 $141.25 Median $1,047.13 Typical High $7,762.47 | Facility | None | $141.25 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $223.87 | Professional | None | $141.25 | $177.83 | $223.87 |
BCBS New Mexico Setting Facility Modifier None Typical Low $151.36 Median $1,778.28 Typical High $4,786.30 | Facility | None | $151.36 | $1,778.28 | $4,786.30 |
BCBS New Mexico Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $239.88 | Professional | None | $95.50 | $173.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $181.97 Typical High $1,202.26 | Facility | None | $151.36 | $181.97 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $316.23 | Professional | None | $158.49 | $234.42 | $316.23 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $162.18 Typical High $269.15 | Professional | None | $32.36 | $162.18 | $269.15 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $218.78 Typical High $1,288.25 | Facility | None | $151.36 | $218.78 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $316.23 | Professional | None | $162.18 | $239.88 | $316.23 |
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 $151.36 Median $229.09 Typical High $323.59 | Professional | None | $151.36 | $229.09 | $323.59 |
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 $70.79 Median $85.11 Typical High $112.20 | Professional | 52 · Reduced service | $70.79 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.88 Typical High $44.67 | Professional | 53 · Discontinued | $28.18 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $128.82 Typical High $169.82 | Professional | 54 · Surgery only | $107.15 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $25.70 Typical High $33.88 | Professional | 55 · Aftercare only | $21.38 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.98 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.13 | $16.98 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $120.23 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $100.00 | $120.23 | $158.49 |
Where New Mexico sits
The same service costs 3.9 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
$219
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.