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 $151.36 Median $1,380.38 Typical High $7,762.47 | Facility | None | $151.36 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $275.42 | Professional | None | $144.54 | $190.55 | $275.42 |
BCBS New Mexico Setting Facility Modifier None Typical Low $436.52 Median $1,584.89 Typical High $2,454.71 | Facility | None | $436.52 | $1,584.89 | $2,454.71 |
BCBS New Mexico Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $281.84 | Professional | None | $107.15 | $177.83 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $223.87 Typical High $1,202.26 | Facility | None | $186.21 | $223.87 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $316.23 | Professional | None | $158.49 | $213.80 | $316.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $181.97 Typical High $309.03 | Professional | None | $33.11 | $181.97 | $309.03 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $263.03 Typical High $1,288.25 | Facility | None | $158.49 | $263.03 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $323.59 | Professional | None | $158.49 | $213.80 | $323.59 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $3,019.95 | Facility | None | $346.74 | $707.95 | $3,019.95 |
United Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $346.74 | Professional | None | $151.36 | $229.09 | $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 $75.86 Median $95.50 Typical High $138.04 | Professional | 52 · Reduced service | $75.86 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.02 Typical High $54.95 | Professional | 53 · Discontinued | $30.20 | $38.02 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $141.25 Typical High $208.93 | Professional | 54 · Surgery only | $112.20 | $141.25 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.18 Typical High $41.69 | Professional | 55 · Aftercare only | $22.39 | $28.18 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.05 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.14 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $131.83 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $104.71 | $131.83 | $194.98 |
Where New Mexico sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 34th of 51
$214
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.