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 $288.40 Median $1,380.38 Typical High $7,762.47 | Facility | None | $288.40 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $512.86 | Professional | None | $269.15 | $380.19 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
BCBS New Mexico Setting Professional Modifier None Typical Low $177.83 Median $316.23 Typical High $524.81 | Professional | None | $177.83 | $316.23 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,698.24 Typical High $2,398.83 | Facility | None | $776.25 | $1,698.24 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $562.34 | Professional | None | $295.12 | $398.11 | $562.34 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $302.00 Typical High $501.19 | Professional | None | $33.11 | $302.00 | $501.19 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $1,513.56 Typical High $2,511.89 | Facility | None | $263.03 | $1,513.56 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $562.34 | Professional | None | $302.00 | $407.38 | $562.34 |
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 $309.03 Median $436.52 Typical High $630.96 | Professional | None | $309.03 | $436.52 | $630.96 |
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 $138.04 Median $190.55 Typical High $257.04 | Professional | 52 · Reduced service | $138.04 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $75.86 Typical High $102.33 | Professional | 53 · Discontinued | $54.95 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $281.84 Typical High $389.05 | Professional | 54 · Surgery only | $204.17 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $56.23 Typical High $77.62 | Professional | 55 · Aftercare only | $41.69 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $38.02 Typical High $51.29 | Professional | 56 · Pre-op care only | $27.54 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $263.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $190.55 | $263.03 | $363.08 |
Where New Mexico sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 27th of 51
$398
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.