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 $158.49 Median $1,047.13 Typical High $7,762.47 | Facility | None | $158.49 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $338.84 | Professional | None | $158.49 | $234.42 | $338.84 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,778.28 Median $6,309.57 Typical High $9,772.37 | Facility | None | $1,778.28 | $6,309.57 | $9,772.37 |
BCBS New Mexico Setting Professional Modifier None Typical Low $125.89 Median $263.03 Typical High $416.87 | Professional | None | $125.89 | $263.03 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $1,288.25 | Facility | None | $537.03 | $891.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $398.11 | Professional | None | $177.83 | $245.47 | $398.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $223.87 Typical High $371.54 | Professional | None | $33.11 | $223.87 | $371.54 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $891.25 Typical High $1,445.44 | Facility | None | $158.49 | $891.25 | $1,445.44 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $416.87 | Professional | None | $177.83 | $263.03 | $416.87 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $446.68 | Professional | None | $169.82 | $269.15 | $446.68 |
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 $79.43 Median $112.20 Typical High $169.82 | Professional | 52 · Reduced service | $79.43 | $112.20 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $44.67 Typical High $67.61 | Professional | 53 · Discontinued | $31.62 | $44.67 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $257.04 | Professional | 54 · Surgery only | $120.23 | $169.82 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.88 Typical High $51.29 | Professional | 55 · Aftercare only | $23.99 | $33.88 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.39 Typical High $33.88 | Professional | 56 · Pre-op care only | $15.85 | $22.39 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $158.49 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $112.20 | $158.49 | $239.88 |
Where New Mexico sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 26th of 51
$269
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.