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 $134.90 Median $1,380.38 Typical High $7,762.47 | Facility | None | $134.90 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $309.03 | Professional | None | $131.83 | $213.80 | $309.03 |
BCBS New Mexico Setting Facility Modifier None Typical Low $194.98 Median $1,380.38 Typical High $4,677.35 | Facility | None | $194.98 | $1,380.38 | $4,677.35 |
BCBS New Mexico Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $295.12 | Professional | None | $120.23 | $199.53 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $234.42 Typical High $1,202.26 | Facility | None | $194.98 | $234.42 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $371.54 | Professional | None | $151.36 | $245.47 | $371.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $199.53 Typical High $331.13 | Professional | None | $33.11 | $199.53 | $331.13 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $1,288.25 | Facility | None | $194.98 | $309.03 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $398.11 | Professional | None | $151.36 | $257.04 | $398.11 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $2,630.27 | Facility | None | $346.74 | $707.95 | $2,630.27 |
United Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $416.87 | Professional | None | $147.91 | $234.42 | $416.87 |
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 $67.61 Median $100.00 Typical High $151.36 | Professional | 52 · Reduced service | $67.61 | $100.00 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $39.81 Typical High $61.66 | Professional | 53 · Discontinued | $26.92 | $39.81 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $147.91 Typical High $229.09 | Professional | 54 · Surgery only | $102.33 | $147.91 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $30.20 Typical High $45.71 | Professional | 55 · Aftercare only | $20.42 | $30.20 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.95 Typical High $30.90 | Professional | 56 · Pre-op care only | $13.49 | $19.95 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $138.04 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $95.50 | $138.04 | $213.80 |
Where New Mexico sits
The same service costs 3.6 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· 37th of 51
$224
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.