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 $125.89 Median $1,047.13 Typical High $7,762.47 | Facility | None | $125.89 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $239.88 | Professional | None | $125.89 | $177.83 | $239.88 |
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 $93.33 Median $154.88 Typical High $251.19 | Professional | None | $93.33 | $154.88 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $181.97 Typical High $602.56 | Facility | None | $151.36 | $181.97 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $338.84 | Professional | None | $154.88 | $223.87 | $338.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $104.71 Typical High $288.40 | Professional | None | $33.11 | $104.71 | $288.40 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $537.03 | Facility | None | $151.36 | $213.80 | $537.03 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $338.84 | Professional | None | $158.49 | $223.87 | $338.84 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $346.74 | Professional | None | $141.25 | $223.87 | $346.74 |
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 $63.10 Median $75.86 Typical High $120.23 | Professional | 52 · Reduced service | $63.10 | $75.86 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.20 Typical High $47.86 | Professional | 53 · Discontinued | $25.12 | $30.20 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $114.82 Typical High $177.83 | Professional | 54 · Surgery only | $93.33 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.91 Typical High $35.48 | Professional | 55 · Aftercare only | $19.05 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.14 Typical High $23.99 | Professional | 56 · Pre-op care only | $12.59 | $15.14 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $107.15 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $87.10 | $107.15 | $165.96 |
Where New Mexico sits
The same service costs 3.5 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· 18th of 51
$224
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.