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 $436.52 Median $1,380.38 Typical High $7,762.47 | Facility | None | $436.52 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $676.08 | Professional | None | $436.52 | $549.54 | $676.08 |
BCBS New Mexico Setting Facility Modifier None Typical Low $4,365.16 Median $15,488.17 Typical High $23,988.33 | Facility | None | $4,365.16 | $15,488.17 | $23,988.33 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,467.37 Typical High $4,897.79 | Facility | None | $776.25 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $933.25 | Professional | None | $467.74 | $660.69 | $933.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $446.68 Typical High $758.58 | Professional | None | $33.11 | $446.68 | $758.58 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $1,513.56 Typical High $5,128.61 | Facility | None | $416.87 | $1,513.56 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $977.24 | Professional | None | $478.63 | $676.08 | $977.24 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $1,023.29 | Professional | None | $467.74 | $707.95 | $1,023.29 |
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 $218.78 Median $275.42 Typical High $338.84 | Professional | 52 · Reduced service | $218.78 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $109.65 Typical High $134.90 | Professional | 53 · Discontinued | $87.10 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $407.38 Typical High $512.86 | Professional | 54 · Surgery only | $331.13 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $102.33 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $54.95 Typical High $67.61 | Professional | 56 · Pre-op care only | $43.65 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $380.19 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $309.03 | $380.19 | $478.63 |
Where New Mexico sits
The same service costs 5.5 times more in Alaska than in Texas. 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· 25th of 51
$676
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.