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 $69.18 Median $1,047.13 Typical High $7,762.47 | Facility | None | $69.18 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $114.82 | Professional | None | $74.13 | $85.11 | $114.82 |
BCBS New Mexico Setting Facility Modifier None Typical Low $154.88 Median $562.34 Typical High $851.14 | Facility | None | $154.88 | $562.34 | $851.14 |
BCBS New Mexico Setting Professional Modifier None Typical Low $47.86 Median $83.18 Typical High $123.03 | Professional | None | $47.86 | $83.18 | $123.03 |
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 $112.20 Typical High $162.18 | Professional | None | $75.86 | $112.20 | $162.18 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $83.18 Typical High $141.25 | Professional | None | $16.60 | $83.18 | $141.25 |
Providence Setting Facility Modifier None Typical Low $63.10 Median $123.03 Typical High $602.56 | Facility | None | $63.10 | $123.03 | $602.56 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $162.18 | Professional | None | $75.86 | $114.82 | $162.18 |
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 $70.79 Median $109.65 Typical High $165.96 | Professional | None | $70.79 | $109.65 | $165.96 |
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 $33.88 Median $40.74 Typical High $57.54 | Professional | 52 · Reduced service | $33.88 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.22 Typical High $22.91 | Professional | 53 · Discontinued | $13.80 | $16.22 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $61.66 Typical High $87.10 | Professional | 54 · Surgery only | $51.29 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.30 Typical High $17.38 | Professional | 55 · Aftercare only | $10.23 | $12.30 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.13 Typical High $11.48 | Professional | 56 · Pre-op care only | $6.92 | $8.13 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $57.54 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $47.86 | $57.54 | $81.28 |
Where New Mexico sits
The same service costs 3.8 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
$115
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.