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 $117.49 Median $1,380.38 Typical High $7,762.47 | Facility | None | $117.49 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $263.03 | Professional | None | $112.20 | $165.96 | $263.03 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,737.80 Median $6,165.95 Typical High $9,549.93 | Facility | None | $1,737.80 | $6,165.95 | $9,549.93 |
BCBS New Mexico Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $251.19 | Professional | None | $83.18 | $138.04 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $218.78 Typical High $1,412.54 | Facility | None | $158.49 | $218.78 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $269.15 | Professional | None | $125.89 | $190.55 | $269.15 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $158.49 Typical High $263.03 | Professional | None | $31.62 | $158.49 | $263.03 |
Providence Setting Facility Modifier None Typical Low $154.88 Median $218.78 Typical High $1,513.56 | Facility | None | $154.88 | $218.78 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $269.15 | Professional | None | $125.89 | $190.55 | $269.15 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $5,011.87 | Facility | None | $575.44 | $1,174.90 | $5,011.87 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $295.12 | Professional | None | $125.89 | $190.55 | $295.12 |
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 $57.54 Median $77.62 Typical High $131.83 | Professional | 52 · Reduced service | $57.54 | $77.62 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $31.62 Typical High $52.48 | Professional | 53 · Discontinued | $22.91 | $31.62 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $117.49 Typical High $199.53 | Professional | 54 · Surgery only | $85.11 | $117.49 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.44 Typical High $39.81 | Professional | 55 · Aftercare only | $16.98 | $23.44 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.85 Typical High $26.30 | Professional | 56 · Pre-op care only | $11.48 | $15.85 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $109.65 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $79.43 | $109.65 | $186.21 |
Where New Mexico sits
The same service costs 3.4 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· 29th of 51
$182
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.