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 $1,412.54 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,412.54 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,995.26 | $1,995.26 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,621.81 | $2,238.72 |
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 $1,288.25 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,621.81 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $389.05 Typical High $1,949.84 | Professional | None | $33.11 | $389.05 | $1,949.84 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $251,188.64 | Facility | None | $602.56 | $1,819.70 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,659.59 | $2,290.87 |
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 $1,318.26 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,905.46 | $2,630.27 |
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 $630.96 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $630.96 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $251.19 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $954.99 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $190.55 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $125.89 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $891.25 | $1,380.38 | $1,380.38 |
Where New Mexico sits
The same service costs 5.0 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· 24th of 51
$1,738
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.