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 $75.86 Median $194.98 Typical High $2,137.96 | Facility | None | $75.86 | $194.98 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $141.25 | Professional | None | $66.07 | $104.71 | $141.25 |
BCBS New Mexico Setting Facility Modifier None Typical Low $147.91 Median $512.86 Typical High $812.83 | Facility | None | $147.91 | $512.86 | $812.83 |
BCBS New Mexico Setting Professional Modifier None Typical Low $48.98 Median $83.18 Typical High $131.83 | Professional | None | $48.98 | $83.18 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Facility | None | $537.03 | $537.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $181.97 | Professional | None | $75.86 | $120.23 | $181.97 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $93.33 Typical High $158.49 | Professional | None | $19.05 | $93.33 | $158.49 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $128.82 Typical High $602.56 | Facility | None | $53.70 | $128.82 | $602.56 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $181.97 | Professional | None | $79.43 | $120.23 | $181.97 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $190.55 | Professional | None | $66.07 | $114.82 | $190.55 |
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 $32.36 Median $38.02 Typical High $64.57 | Professional | 52 · Reduced service | $32.36 | $38.02 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.14 Typical High $25.70 | Professional | 53 · Discontinued | $12.88 | $15.14 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $57.54 Typical High $97.72 | Professional | 54 · Surgery only | $47.86 | $57.54 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.48 Typical High $19.50 | Professional | 55 · Aftercare only | $9.77 | $11.48 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.59 Typical High $12.88 | Professional | 56 · Pre-op care only | $6.46 | $7.59 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $44.67 Median $53.70 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $44.67 | $53.70 | $91.20 |
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· 23rd of 51
$112
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.