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 $83.18 Median $1,047.13 Typical High $7,762.47 | Facility | None | $83.18 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $169.82 | Professional | None | $85.11 | $125.89 | $169.82 |
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 $61.66 Median $104.71 Typical High $177.83 | Professional | None | $61.66 | $104.71 | $177.83 |
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 $104.71 Median $158.49 Typical High $239.88 | Professional | None | $104.71 | $158.49 | $239.88 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $104.71 Typical High $208.93 | Professional | None | $25.12 | $104.71 | $208.93 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $165.96 Typical High $602.56 | Facility | None | $79.43 | $165.96 | $602.56 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $239.88 | Professional | None | $107.15 | $158.49 | $239.88 |
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 $93.33 Median $147.91 Typical High $245.47 | Professional | None | $93.33 | $147.91 | $245.47 |
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 $41.69 Median $50.12 Typical High $85.11 | Professional | 52 · Reduced service | $41.69 | $50.12 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.95 Typical High $33.88 | Professional | 53 · Discontinued | $16.60 | $19.95 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $74.13 Typical High $125.89 | Professional | 54 · Surgery only | $63.10 | $74.13 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.14 Typical High $25.70 | Professional | 55 · Aftercare only | $12.59 | $15.14 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.00 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.32 | $10.00 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $69.18 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $58.88 | $69.18 | $117.49 |
Where New Mexico sits
The same service costs 3.5 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· 21st of 51
$155
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.