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 $162.18 Median $1,047.13 Typical High $7,762.47 | Facility | None | $162.18 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $295.12 | Professional | None | $162.18 | $234.42 | $295.12 |
BCBS New Mexico Setting Facility Modifier None Typical Low $186.21 Median $1,380.38 Typical High $4,677.35 | Facility | None | $186.21 | $1,380.38 | $4,677.35 |
BCBS New Mexico Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $309.03 | Professional | None | $112.20 | $199.53 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $1,202.26 | Facility | None | $190.55 | $229.09 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $407.38 | Professional | None | $194.98 | $281.84 | $407.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $213.80 Typical High $354.81 | Professional | None | $33.11 | $213.80 | $354.81 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $275.42 Typical High $1,288.25 | Facility | None | $158.49 | $275.42 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $426.58 | Professional | None | $194.98 | $281.84 | $426.58 |
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 $173.78 Median $281.84 Typical High $426.58 | Professional | None | $173.78 | $281.84 | $426.58 |
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 $81.28 Median $97.72 Typical High $147.91 | Professional | 52 · Reduced service | $81.28 | $97.72 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $39.81 Typical High $58.88 | Professional | 53 · Discontinued | $32.36 | $39.81 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $147.91 Typical High $218.78 | Professional | 54 · Surgery only | $123.03 | $147.91 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $29.51 Typical High $43.65 | Professional | 55 · Aftercare only | $24.55 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.50 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.22 | $19.50 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $138.04 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $114.82 | $138.04 | $204.17 |
Where New Mexico sits
The same service costs 3.4 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· 19th of 51
$275
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.