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 $263.03 Median $2,041.74 Typical High $7,762.47 | Facility | None | $263.03 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $354.81 | Professional | None | $234.42 | $346.74 | $354.81 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,511.89 Median $9,120.11 Typical High $13,803.84 | Facility | None | $2,511.89 | $9,120.11 | $13,803.84 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,819.70 Typical High $2,951.21 | Facility | None | $776.25 | $1,819.70 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $398.11 | Professional | None | $263.03 | $302.00 | $398.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $70.79 Typical High $354.81 | Professional | None | $33.11 | $70.79 | $354.81 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $1,819.70 Typical High $2,951.21 | Facility | None | $338.84 | $1,819.70 | $2,951.21 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $416.87 | Professional | None | $263.03 | $309.03 | $416.87 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $457.09 | Professional | None | $245.47 | $338.84 | $457.09 |
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 $120.23 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $120.23 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $47.86 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $177.83 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $35.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $23.99 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $245.47 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $165.96 | $245.47 | $245.47 |
Where New Mexico sits
The same service costs 6.0 times more in Alaska than in Utah. 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· 22nd of 51
$347
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.