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 $218.78 Median $1,047.13 Typical High $7,762.47 | Facility | None | $218.78 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $331.13 | Professional | None | $218.78 | $275.42 | $331.13 |
BCBS New Mexico Setting Facility Modifier None Typical Low $398.11 Median $1,047.13 Typical High $3,981.07 | Facility | None | $398.11 | $1,047.13 | $3,981.07 |
BCBS New Mexico Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $380.19 | Professional | None | $144.54 | $269.15 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $1,288.25 | Facility | None | $537.03 | $891.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $467.74 | Professional | None | $239.88 | $363.08 | $467.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $239.88 Typical High $398.11 | Professional | None | $33.11 | $239.88 | $398.11 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $891.25 Typical High $1,445.44 | Facility | None | $218.78 | $891.25 | $1,445.44 |
Providence Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $467.74 | Professional | None | $251.19 | $371.54 | $467.74 |
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 $239.88 Median $354.81 Typical High $478.63 | Professional | None | $239.88 | $354.81 | $478.63 |
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 $109.65 Median $131.83 Typical High $165.96 | Professional | 52 · Reduced service | $109.65 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $52.48 Typical High $66.07 | Professional | 53 · Discontinued | $43.65 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $199.53 Typical High $251.19 | Professional | 54 · Surgery only | $162.18 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $39.81 Typical High $50.12 | Professional | 55 · Aftercare only | $33.11 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $26.30 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.88 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $186.21 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $151.36 | $186.21 | $234.42 |
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
$347
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.