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 $1,000.00 Median $1,548.82 Typical High $8,709.64 | Facility | None | $1,000.00 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,659.59 | $1,659.59 |
BCBS New Mexico Setting Facility Modifier None Typical Low $8,317.64 Median $14,125.38 Typical High $27,542.29 | Facility | None | $8,317.64 | $14,125.38 | $27,542.29 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,548.82 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,000.00 Typical High $13,803.84 | Facility | None | $602.56 | $10,000.00 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,479.11 | $2,187.76 |
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 $602.56 Median $1,862.09 Typical High $14,454.40 | Facility | None | $602.56 | $1,862.09 | $14,454.40 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,479.11 | $2,344.23 |
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 $1,148.15 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,778.28 | $2,344.23 |
4 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 54 · Surgery only Typical Low $870.96 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $870.96 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $173.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $117.49 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $812.83 | $1,174.90 | $1,174.90 |
Where New Mexico sits
The same service costs 8.1 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· 24th of 51
$1,820
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.