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 $47.86 Median $1,000.00 Typical High $7,762.47 | Facility | None | $47.86 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $57.54 Typical High $61.66 | Professional | None | $47.86 | $57.54 | $61.66 |
BCBS New Mexico Setting Professional Modifier None Typical Low $26.30 Median $58.88 Typical High $74.13 | Professional | None | $26.30 | $58.88 | $74.13 |
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 $50.12 Median $69.18 Typical High $89.13 | Professional | None | $50.12 | $69.18 | $89.13 |
Molina Setting Professional Modifier None Typical Low $8.91 Median $44.67 Typical High $75.86 | Professional | None | $8.91 | $44.67 | $75.86 |
Providence Setting Facility Modifier None Typical Low $46.77 Median $63.10 Typical High $602.56 | Facility | None | $46.77 | $63.10 | $602.56 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $93.33 | Professional | None | $53.70 | $74.13 | $93.33 |
United Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $1,318.26 | Facility | None | $199.53 | $245.47 | $1,318.26 |
United Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $89.13 | Professional | None | $42.66 | $70.79 | $89.13 |
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 $23.99 Median $28.84 Typical High $30.90 | Professional | 52 · Reduced service | $23.99 | $28.84 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.48 Typical High $12.30 | Professional | 53 · Discontinued | $9.55 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $43.65 Typical High $45.71 | Professional | 54 · Surgery only | $35.48 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.71 Typical High $9.33 | Professional | 55 · Aftercare only | $7.08 | $8.71 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.75 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.79 | $5.75 | $6.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.11 Median $40.74 Typical High $42.66 | Professional | 78 · Unplanned return to OR | $33.11 | $40.74 | $42.66 |
Where New Mexico sits
The same service costs 4.6 times more in Alaska than in New York. 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· 22nd of 51
$63.10
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.