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 $154.88 Median $1,047.13 Typical High $7,762.47 | Facility | None | $154.88 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $331.13 | Professional | None | $147.91 | $204.17 | $331.13 |
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 $190.55 Median $229.09 Typical High $1,202.26 | Facility | None | $190.55 | $229.09 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $363.08 | Professional | None | $169.82 | $257.04 | $363.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $190.55 Typical High $316.23 | Professional | None | $33.11 | $190.55 | $316.23 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $275.42 Typical High $1,288.25 | Facility | None | $158.49 | $275.42 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $363.08 | Professional | None | $169.82 | $263.03 | $363.08 |
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 $169.82 Median $257.04 Typical High $389.05 | Professional | None | $169.82 | $257.04 | $389.05 |
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 $74.13 Median $102.33 Typical High $165.96 | Professional | 52 · Reduced service | $74.13 | $102.33 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $40.74 Typical High $66.07 | Professional | 53 · Discontinued | $29.51 | $40.74 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $151.36 Typical High $245.47 | Professional | 54 · Surgery only | $109.65 | $151.36 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $30.90 Typical High $48.98 | Professional | 55 · Aftercare only | $22.39 | $30.90 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $20.42 Typical High $33.11 | Professional | 56 · Pre-op care only | $14.79 | $20.42 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $141.25 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $102.33 | $141.25 | $229.09 |
Where New Mexico sits
The same service costs 3.5 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· 26th of 51
$240
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.