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 $234.42 Median $1,047.13 Typical High $7,762.47 | Facility | None | $234.42 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $501.19 | Professional | None | $229.09 | $323.59 | $501.19 |
BCBS New Mexico Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $489.78 | Professional | None | $158.49 | $269.15 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $416.87 Typical High $602.56 | Facility | None | $302.00 | $416.87 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $501.19 | Professional | None | $239.88 | $331.13 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $295.12 Typical High $489.78 | Professional | None | $33.11 | $295.12 | $489.78 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $398.11 Typical High $602.56 | Facility | None | $302.00 | $398.11 | $602.56 |
Providence Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $501.19 | Professional | None | $239.88 | $331.13 | $501.19 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $549.54 | Professional | None | $251.19 | $363.08 | $549.54 |
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 $114.82 Median $162.18 Typical High $251.19 | Professional | 52 · Reduced service | $114.82 | $162.18 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $64.57 Typical High $100.00 | Professional | 53 · Discontinued | $45.71 | $64.57 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $371.54 | Professional | 54 · Surgery only | $169.82 | $239.88 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $47.86 Typical High $75.86 | Professional | 55 · Aftercare only | $33.88 | $47.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $32.36 Typical High $50.12 | Professional | 56 · Pre-op care only | $22.91 | $32.36 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $223.87 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $158.49 | $223.87 | $346.74 |
Where New Mexico sits
The same service costs 3.6 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· 34th of 51
$331
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.