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 $199.53 Median $1,047.13 Typical High $7,762.47 | Facility | None | $199.53 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $288.40 | Professional | None | $186.21 | $245.47 | $288.40 |
BCBS New Mexico Setting Facility Modifier None Typical Low $165.96 Median $602.56 Typical High $933.25 | Facility | None | $165.96 | $602.56 | $933.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $114.82 Median $234.42 Typical High $316.23 | Professional | None | $114.82 | $234.42 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $602.56 | Facility | None | $158.49 | $190.55 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $346.74 | Professional | None | $199.53 | $269.15 | $346.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $181.97 Typical High $302.00 | Professional | None | $33.11 | $181.97 | $302.00 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $229.09 Typical High $537.03 | Facility | None | $162.18 | $229.09 | $537.03 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $363.08 | Professional | None | $199.53 | $269.15 | $363.08 |
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 $181.97 Median $275.42 Typical High $371.54 | Professional | None | $181.97 | $275.42 | $371.54 |
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 $97.72 Median $123.03 Typical High $134.90 | Professional | 52 · Reduced service | $97.72 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $48.98 Typical High $53.70 | Professional | 53 · Discontinued | $39.81 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $147.91 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $29.51 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $24.55 Typical High $26.92 | Professional | 56 · Pre-op care only | $19.95 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $169.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $138.04 | $169.82 | $190.55 |
Where New Mexico sits
The same service costs 4.8 times more in Alaska than in Florida. 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· 30th of 51
$245
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.