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 $794.33 Median $2,089.30 Typical High $8,709.64 | Facility | None | $794.33 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | None | $724.44 | $1,071.52 | $1,071.52 |
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 $741.31 Median $3,467.37 Typical High $4,897.79 | Facility | None | $741.31 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,202.26 | Professional | None | $724.44 | $891.25 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $208.93 Typical High $1,047.13 | Professional | None | $33.11 | $208.93 | $1,047.13 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $3,090.30 Typical High $5,128.61 | Facility | None | $537.03 | $3,090.30 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,258.93 | Professional | None | $794.33 | $912.01 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,348.96 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,380.38 | Professional | None | $741.31 | $1,023.29 | $1,380.38 |
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 $363.08 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $363.08 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $144.54 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $549.54 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $72.44 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $512.86 | $741.31 | $741.31 |
Where New Mexico sits
The same service costs 6.2 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· 18th of 51
$1,023
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.