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 $151.36 Median $1,047.13 Typical High $7,762.47 | Facility | None | $151.36 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $223.87 | Professional | None | $151.36 | $190.55 | $223.87 |
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 $85.11 Median $181.97 Typical High $229.09 | Professional | None | $85.11 | $181.97 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $186.21 Typical High $602.56 | Facility | None | $154.88 | $186.21 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $275.42 | Professional | None | $162.18 | $199.53 | $275.42 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $154.88 Typical High $257.04 | Professional | None | $30.90 | $154.88 | $257.04 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $537.03 | Facility | None | $162.18 | $218.78 | $537.03 |
Providence Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $295.12 | Professional | None | $162.18 | $213.80 | $295.12 |
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 $147.91 Median $218.78 Typical High $309.03 | Professional | None | $147.91 | $218.78 | $309.03 |
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 $75.86 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $75.86 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.02 Typical High $45.71 | Professional | 53 · Discontinued | $30.90 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $114.82 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $22.91 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.14 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $131.83 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $107.15 | $131.83 | $158.49 |
Where New Mexico sits
The same service costs 4.6 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· 31st of 51
$200
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.