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 $144.54 Median $436.52 Typical High $7,762.47 | Facility | None | $144.54 | $436.52 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $436.52 | Professional | None | $144.54 | $251.19 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
BCBS New Mexico Setting Facility Modifier None Typical Low $147.91 Median $524.81 Typical High $812.83 | Facility | None | $147.91 | $524.81 | $812.83 |
BCBS New Mexico Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $457.09 | Professional | None | $144.54 | $239.88 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $154.88 Typical High $602.56 | Facility | None | $128.82 | $154.88 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $467.74 | Professional | None | $147.91 | $269.15 | $467.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $281.84 Typical High $467.74 | Professional | None | $33.11 | $281.84 | $467.74 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $186.21 Typical High $537.03 | Facility | None | $128.82 | $186.21 | $537.03 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $478.63 | Professional | None | $147.91 | $275.42 | $478.63 |
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 $144.54 Median $251.19 Typical High $467.74 | Professional | None | $144.54 | $251.19 | $467.74 |
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 $72.44 Median $102.33 Typical High $218.78 | Professional | 52 · Reduced service | $72.44 | $102.33 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $40.74 Typical High $87.10 | Professional | 53 · Discontinued | $28.84 | $40.74 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $331.13 | Professional | 54 · Surgery only | $107.15 | $154.88 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $66.07 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.42 Typical High $43.65 | Professional | 56 · Pre-op care only | $14.45 | $20.42 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $309.03 |
Where New Mexico sits
The same service costs 3.6 times more in Wisconsin 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· 37th of 51
$251
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.