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 $117.49 Median $1,047.13 Typical High $7,762.47 | Facility | None | $117.49 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $223.87 | Professional | None | $117.49 | $165.96 | $223.87 |
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 $85.11 Median $144.54 Typical High $229.09 | Professional | None | $85.11 | $144.54 | $229.09 |
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 $147.91 Median $208.93 Typical High $316.23 | Professional | None | $147.91 | $208.93 | $316.23 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $104.71 Typical High $269.15 | Professional | None | $32.36 | $104.71 | $269.15 |
Providence Setting Facility Modifier None Typical Low $114.82 Median $229.09 Typical High $602.56 | Facility | None | $114.82 | $229.09 | $602.56 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $316.23 | Professional | None | $147.91 | $208.93 | $316.23 |
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 $131.83 Median $208.93 Typical High $323.59 | Professional | None | $131.83 | $208.93 | $323.59 |
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 $58.88 Median $70.79 Typical High $112.20 | Professional | 52 · Reduced service | $58.88 | $70.79 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $28.18 Typical High $44.67 | Professional | 53 · Discontinued | $23.44 | $28.18 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $107.15 Typical High $165.96 | Professional | 54 · Surgery only | $89.13 | $107.15 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $21.38 Typical High $33.11 | Professional | 55 · Aftercare only | $17.78 | $21.38 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.13 Typical High $22.39 | Professional | 56 · Pre-op care only | $11.75 | $14.13 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $100.00 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $83.18 | $100.00 | $154.88 |
Where New Mexico sits
The same service costs 3.3 times more in Alaska than in Maryland. 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
$209
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.