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 $1,000.00 Median $2,041.74 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,698.24 | $1,698.24 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,584.89 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $10,232.93 Typical High $14,454.40 | Facility | None | $776.25 | $10,232.93 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,479.11 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $371.54 Typical High $1,862.09 | Professional | None | $33.11 | $371.54 | $1,862.09 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $2,754.23 Typical High $14,791.08 | Facility | None | $776.25 | $2,754.23 | $14,791.08 |
Providence Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,479.11 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $24,547.09 | Facility | None | $1,995.26 | $5,495.41 | $24,547.09 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,737.80 | $2,344.23 |
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 $588.84 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $588.84 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $234.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $891.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $177.83 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $117.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $831.76 | $1,174.90 | $1,174.90 |
Where New Mexico sits
The same service costs 7.4 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· 29th of 51
$1,622
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.