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 $131.83 Median $1,047.13 Typical High $7,762.47 | Facility | None | $131.83 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $239.88 | Professional | None | $151.36 | $186.21 | $239.88 |
BCBS New Mexico Setting Facility Modifier None Typical Low $281.84 Median $1,023.29 Typical High $1,548.82 | Facility | None | $281.84 | $1,023.29 | $1,548.82 |
BCBS New Mexico Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $251.19 | Professional | None | $95.50 | $165.96 | $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 $158.49 Median $229.09 Typical High $338.84 | Professional | None | $158.49 | $229.09 | $338.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $177.83 Typical High $295.12 | Professional | None | $33.11 | $177.83 | $295.12 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $208.93 Typical High $537.03 | Facility | None | $151.36 | $208.93 | $537.03 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $346.74 | Professional | None | $165.96 | $229.09 | $346.74 |
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 $147.91 Median $234.42 Typical High $346.74 | Professional | None | $147.91 | $234.42 | $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 $66.07 Median $79.43 Typical High $120.23 | Professional | 52 · Reduced service | $66.07 | $79.43 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $31.62 Typical High $47.86 | Professional | 53 · Discontinued | $26.30 | $31.62 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $120.23 Typical High $181.97 | Professional | 54 · Surgery only | $100.00 | $120.23 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $36.31 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.85 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.18 | $15.85 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $112.20 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $93.33 | $112.20 | $169.82 |
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
$229
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.