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 $218.78 Typical High $331.13 | Professional | None | $158.49 | $218.78 | $331.13 |
BCBS New Mexico Setting Facility Modifier None Typical Low $831.76 Median $2,951.21 Typical High $4,570.88 | Facility | None | $831.76 | $2,951.21 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $257.04 Typical High $1,202.26 | Facility | None | $213.80 | $257.04 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $398.11 | Professional | None | $181.97 | $275.42 | $398.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $213.80 Typical High $363.08 | Professional | None | $33.11 | $213.80 | $363.08 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $309.03 Typical High $1,288.25 | Facility | None | $158.49 | $309.03 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $281.84 Typical High $416.87 | Professional | None | $181.97 | $281.84 | $416.87 |
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 $165.96 Median $263.03 Typical High $436.52 | Professional | None | $165.96 | $263.03 | $436.52 |
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 $109.65 Typical High $165.96 | Professional | 52 · Reduced service | $79.43 | $109.65 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $43.65 Typical High $66.07 | Professional | 53 · Discontinued | $31.62 | $43.65 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $165.96 Typical High $245.47 | Professional | 54 · Surgery only | $120.23 | $165.96 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $48.98 | Professional | 55 · Aftercare only | $23.99 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $33.11 | Professional | 56 · Pre-op care only | $15.85 | $21.88 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $154.88 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $112.20 | $154.88 | $229.09 |
Where New Mexico sits
The same service costs 4.4 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· 23rd 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.