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 $229.09 Median $1,380.38 Typical High $7,762.47 | Facility | None | $229.09 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $398.11 | Professional | None | $229.09 | $309.03 | $398.11 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,778.28 Median $6,309.57 Typical High $9,772.37 | Facility | None | $1,778.28 | $6,309.57 | $9,772.37 |
BCBS New Mexico Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $407.38 | Professional | None | $154.88 | $281.84 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,479.11 | Facility | None | $776.25 | $1,000.00 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $549.54 | Professional | None | $257.04 | $389.05 | $549.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $288.40 Typical High $478.63 | Professional | None | $33.11 | $288.40 | $478.63 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $977.24 Typical High $1,513.56 | Facility | None | $251.19 | $977.24 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $562.34 | Professional | None | $269.15 | $398.11 | $562.34 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $575.44 | Professional | None | $245.47 | $389.05 | $575.44 |
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 $114.82 Median $141.25 Typical High $194.98 | Professional | 52 · Reduced service | $114.82 | $141.25 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $56.23 Typical High $79.43 | Professional | 53 · Discontinued | $45.71 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $208.93 Typical High $295.12 | Professional | 54 · Surgery only | $173.78 | $208.93 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $41.69 Typical High $58.88 | Professional | 55 · Aftercare only | $34.67 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.18 Typical High $39.81 | Professional | 56 · Pre-op care only | $22.91 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $194.98 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $162.18 | $194.98 | $275.42 |
Where New Mexico sits
The same service costs 4.0 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
$398
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.