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 $1,000.00 Median $2,089.30 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,089.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,238.72 | $3,715.35 | $3,715.35 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $4,365.16 | Professional | None | $1,995.26 | $3,019.95 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $707.95 | Facility | None | $537.03 | $602.56 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $4,073.80 | Professional | None | $2,398.83 | $3,019.95 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $724.44 Typical High $3,630.78 | Professional | None | $33.11 | $724.44 | $3,630.78 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $3,388.44 Typical High $251,188.64 | Facility | None | $602.56 | $3,388.44 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,691.53 Median $3,090.30 Typical High $4,265.80 | Professional | None | $2,691.53 | $3,090.30 | $4,265.80 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,412.54 Typical High $10,471.29 | Facility | None | $407.38 | $1,412.54 | $10,471.29 |
United Setting Professional Modifier None Typical Low $2,454.71 Median $3,548.13 Typical High $4,786.30 | Professional | None | $2,454.71 | $3,548.13 | $4,786.30 |
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 $1,174.90 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,174.90 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $467.74 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,737.80 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $346.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $234.42 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,621.81 | $2,570.40 | $2,570.40 |
Where New Mexico sits
The same service costs 21.4 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· 23rd of 51
$3,311
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.