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 $177.83 Median $1,380.38 Typical High $7,762.47 | Facility | None | $177.83 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $363.08 | Professional | None | $165.96 | $245.47 | $363.08 |
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 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $257.04 Typical High $1,412.54 | Facility | None | $213.80 | $257.04 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $407.38 | Professional | None | $199.53 | $295.12 | $407.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $208.93 Typical High $346.74 | Professional | None | $33.11 | $208.93 | $346.74 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $309.03 Typical High $1,513.56 | Facility | None | $213.80 | $309.03 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $407.38 | Professional | None | $199.53 | $295.12 | $407.38 |
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 $199.53 Median $288.40 Typical High $446.68 | Professional | None | $199.53 | $288.40 | $446.68 |
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 $85.11 Median $117.49 Typical High $181.97 | Professional | 52 · Reduced service | $85.11 | $117.49 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $46.77 Typical High $72.44 | Professional | 53 · Discontinued | $33.88 | $46.77 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $173.78 Typical High $275.42 | Professional | 54 · Surgery only | $128.82 | $173.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $34.67 Typical High $54.95 | Professional | 55 · Aftercare only | $25.70 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.44 Typical High $36.31 | Professional | 56 · Pre-op care only | $16.98 | $23.44 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $162.18 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $120.23 | $162.18 | $257.04 |
Where New Mexico sits
The same service costs 3.6 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
$282
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.