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 $758.58 Median $2,089.30 Typical High $8,912.51 | Facility | None | $758.58 | $2,089.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,258.93 Typical High $2,089.30 | Professional | None | $758.58 | $1,258.93 | $2,089.30 |
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 $1,047.13 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,047.13 | $3,467.37 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,621.81 Typical High $2,754.23 | Professional | None | $870.96 | $1,621.81 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,348.96 Typical High $2,238.72 | Professional | None | $33.11 | $1,348.96 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $3,467.37 Typical High $6,165.95 | Facility | None | $616.60 | $3,467.37 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,698.24 Typical High $2,754.23 | Professional | None | $954.99 | $1,698.24 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,348.96 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,479.11 Typical High $3,019.95 | Professional | None | $851.14 | $1,479.11 | $3,019.95 |
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 $380.19 Median $630.96 Typical High $1,047.13 | Professional | 52 · Reduced service | $380.19 | $630.96 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $251.19 Typical High $416.87 | Professional | 53 · Discontinued | $151.36 | $251.19 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $954.99 Typical High $1,584.89 | Professional | 54 · Surgery only | $562.34 | $954.99 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $190.55 Typical High $316.23 | Professional | 55 · Aftercare only | $112.20 | $190.55 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $125.89 Typical High $208.93 | Professional | 56 · Pre-op care only | $75.86 | $125.89 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $891.25 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $524.81 | $891.25 | $1,479.11 |
Where New Mexico sits
The same service costs 4.9 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· 22nd of 51
$1,622
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.