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 $3,388.44 Median $5,370.32 Typical High $5,370.32 | Professional | None | $3,388.44 | $5,370.32 | $5,370.32 |
BCBS New Mexico Setting Professional Modifier None Typical Low $3,090.30 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,090.30 | $4,365.16 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,047.13 Typical High $5,248.07 | Professional | None | $33.11 | $1,047.13 | $5,248.07 |
Providence Setting Facility Modifier None Typical Low $3,235.94 Median $4,677.35 Typical High $4,786.30 | Facility | None | $3,235.94 | $4,677.35 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $6,025.60 Median $7,943.28 Typical High $9,549.93 | Professional | None | $6,025.60 | $7,943.28 | $9,549.93 |
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 $3,548.13 Median $5,128.61 Typical High $6,918.31 | Professional | None | $3,548.13 | $5,128.61 | $6,918.31 |
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 $1,698.24 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,698.24 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $676.08 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $3,981.07 Typical High $3,981.07 | Professional | 54 · Surgery only | $2,511.89 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $794.33 Typical High $794.33 | Professional | 55 · Aftercare only | $501.19 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $338.84 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $3,715.35 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,344.23 | $3,715.35 | $3,715.35 |
Where New Mexico sits
The same service costs 27.5 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· 21st of 51
$4,898
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.