How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $190.55 Median $1,047.13 Typical High $7,762.47 | Facility | None | $190.55 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $323.59 | Professional | None | $190.55 | $234.42 | $323.59 |
BCBS New Mexico Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $363.08 | Professional | None | $138.04 | $239.88 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $1,202.26 | Facility | None | $181.97 | $218.78 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $457.09 | Professional | None | $223.87 | $331.13 | $457.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $190.55 Typical High $389.05 | Professional | None | $33.11 | $190.55 | $389.05 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $263.03 Typical High $1,288.25 | Facility | None | $181.97 | $263.03 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $467.74 | Professional | None | $245.47 | $331.13 | $467.74 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,445.44 | Facility | None | $199.53 | $275.42 | $1,445.44 |
United Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $478.63 | Professional | None | $218.78 | $331.13 | $478.63 |
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 $95.50 Median $117.49 Typical High $162.18 | Professional | 52 · Reduced service | $95.50 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $64.57 | Professional | 53 · Discontinued | $38.02 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $173.78 Typical High $239.88 | Professional | 54 · Surgery only | $144.54 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $34.67 Typical High $47.86 | Professional | 55 · Aftercare only | $28.84 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $162.18 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $134.90 | $162.18 | $223.87 |
Where New Mexico sits
The same service costs 3.6 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· 17th of 51
$316
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.