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 $338.84 Median $1,548.82 Typical High $8,709.64 | Facility | None | $338.84 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $562.34 | Professional | None | $338.84 | $426.58 | $562.34 |
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 $602.56 Median $1,698.24 Typical High $2,691.53 | Facility | None | $602.56 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $691.83 | Professional | None | $354.81 | $489.78 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $380.19 Typical High $630.96 | Professional | None | $33.11 | $380.19 | $630.96 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $1,698.24 Typical High $2,691.53 | Facility | None | $338.84 | $1,698.24 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $724.44 | Professional | None | $363.08 | $489.78 | $724.44 |
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 $331.13 Median $501.19 Typical High $758.58 | Professional | None | $331.13 | $501.19 | $758.58 |
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 $165.96 Median $208.93 Typical High $281.84 | Professional | 52 · Reduced service | $165.96 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $85.11 Typical High $114.82 | Professional | 53 · Discontinued | $67.61 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $426.58 | Professional | 54 · Surgery only | $251.19 | $316.23 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $85.11 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $42.66 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.88 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $295.12 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $234.42 | $295.12 | $398.11 |
Where New Mexico sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$501
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.