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 $107.15 Median $1,047.13 Typical High $7,762.47 | Facility | None | $107.15 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $204.17 | Professional | None | $107.15 | $147.91 | $204.17 |
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 $75.86 Median $131.83 Typical High $218.78 | Professional | None | $75.86 | $131.83 | $218.78 |
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 $131.83 Median $190.55 Typical High $288.40 | Professional | None | $131.83 | $190.55 | $288.40 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $104.71 Typical High $251.19 | Professional | None | $30.20 | $104.71 | $251.19 |
Providence Setting Facility Modifier None Typical Low $104.71 Median $204.17 Typical High $602.56 | Facility | None | $104.71 | $204.17 | $602.56 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $288.40 | Professional | None | $131.83 | $190.55 | $288.40 |
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 $120.23 Median $190.55 Typical High $295.12 | Professional | None | $120.23 | $190.55 | $295.12 |
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 $52.48 Median $64.57 Typical High $102.33 | Professional | 52 · Reduced service | $52.48 | $64.57 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.70 Typical High $41.69 | Professional | 53 · Discontinued | $21.38 | $25.70 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $95.50 Typical High $154.88 | Professional | 54 · Surgery only | $79.43 | $95.50 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $30.90 | Professional | 55 · Aftercare only | $15.85 | $19.05 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $89.13 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $74.13 | $89.13 | $144.54 |
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
$191
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.