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 $933.25 Median $1,548.82 Typical High $8,709.64 | Facility | None | $933.25 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,202.26 | Professional | None | $831.76 | $1,202.26 | $1,202.26 |
BCBS New Mexico Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,698.24 | Professional | None | $812.83 | $1,122.02 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $263.03 Typical High $1,318.26 | Professional | None | $33.11 | $263.03 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,288.25 | Facility | None | $870.96 | $1,258.93 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $1,778.28 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,778.28 | $2,137.96 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,348.96 | $4,786.30 | $14,125.38 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,659.59 | Professional | None | $812.83 | $1,258.93 | $1,659.59 |
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 $416.87 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $416.87 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $169.82 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $630.96 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $125.89 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $83.18 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $588.84 | $831.76 | $831.76 |
Where New Mexico sits
The same service costs 17.4 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· 26th of 51
$1,202
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.