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 $173.78 Median $1,047.13 Typical High $7,762.47 | Facility | None | $173.78 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $269.15 | Professional | None | $173.78 | $218.78 | $269.15 |
BCBS New Mexico Setting Facility Modifier None Typical Low $165.96 Median $1,380.38 Typical High $4,677.35 | Facility | None | $165.96 | $1,380.38 | $4,677.35 |
BCBS New Mexico Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $302.00 | Professional | None | $117.49 | $213.80 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $199.53 Typical High $1,202.26 | Facility | None | $165.96 | $199.53 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $371.54 | Professional | None | $190.55 | $288.40 | $371.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $194.98 Typical High $323.59 | Professional | None | $33.11 | $194.98 | $323.59 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $1,288.25 | Facility | None | $165.96 | $245.47 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $371.54 | Professional | None | $199.53 | $295.12 | $371.54 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $3,019.95 | Facility | None | $346.74 | $707.95 | $3,019.95 |
United Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $389.05 | Professional | None | $186.21 | $281.84 | $389.05 |
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 $87.10 Median $104.71 Typical High $131.83 | Professional | 52 · Reduced service | $87.10 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $41.69 Typical High $53.70 | Professional | 53 · Discontinued | $34.67 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $154.88 Typical High $199.53 | Professional | 54 · Surgery only | $128.82 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.89 Typical High $26.92 | Professional | 56 · Pre-op care only | $17.38 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $144.54 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $120.23 | $144.54 | $186.21 |
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· 21st of 51
$269
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.