How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $371.54 Median $1,047.13 Typical High $7,762.47 | Facility | None | $371.54 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $512.86 | Professional | None | $354.81 | $467.74 | $512.86 |
BCBS New Mexico Setting Professional Modifier None Typical Low $186.21 Median $446.68 Typical High $575.44 | Professional | None | $186.21 | $446.68 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $1,202.26 | Facility | None | $158.49 | $190.55 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $630.96 | Professional | None | $346.74 | $467.74 | $630.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $346.74 Typical High $575.44 | Professional | None | $33.11 | $346.74 | $575.44 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $338.84 Typical High $1,288.25 | Facility | None | $158.49 | $338.84 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $676.08 | Professional | None | $354.81 | $478.63 | $676.08 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $707.95 | Professional | None | $316.23 | $501.19 | $707.95 |
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 $177.83 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $177.83 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $70.79 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $269.15 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $70.79 Typical High $75.86 | Professional | 55 · Aftercare only | $53.70 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $35.48 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $331.13 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $251.19 | $331.13 | $354.81 |
Where New Mexico sits
The same service costs 5.2 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
$468
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.