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 $309.03 Median $1,380.38 Typical High $7,762.47 | Facility | None | $309.03 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $467.74 | Professional | None | $309.03 | $380.19 | $467.74 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,344.23 Median $8,511.38 Typical High $13,182.57 | Facility | None | $2,344.23 | $8,511.38 | $13,182.57 |
BCBS New Mexico Setting Professional Modifier None Typical Low $194.98 Median $380.19 Typical High $501.19 | Professional | None | $194.98 | $380.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,445.44 Typical High $1,995.26 | Facility | None | $776.25 | $1,445.44 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $630.96 | Professional | None | $338.84 | $501.19 | $630.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $331.13 Typical High $549.54 | Professional | None | $33.11 | $331.13 | $549.54 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $1,445.44 Typical High $2,089.30 | Facility | None | $302.00 | $1,445.44 | $2,089.30 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $645.65 | Professional | None | $363.08 | $524.81 | $645.65 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $660.69 | Professional | None | $323.59 | $501.19 | $660.69 |
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 $154.88 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $154.88 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $61.66 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $338.84 | Professional | 54 · Surgery only | $234.42 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $56.23 Typical High $67.61 | Professional | 55 · Aftercare only | $46.77 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.90 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $263.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $218.78 | $263.03 | $316.23 |
Where New Mexico sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 24th of 51
$457
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.