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 $186.21 Median $1,380.38 Typical High $7,762.47 | Facility | None | $186.21 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $346.74 | Professional | None | $186.21 | $263.03 | $346.74 |
BCBS New Mexico Setting Facility Modifier None Typical Low $724.44 Median $2,630.27 Typical High $3,981.07 | Facility | None | $724.44 | $2,630.27 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $1,412.54 | Facility | None | $562.34 | $676.08 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $371.54 | Professional | None | $204.17 | $275.42 | $371.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $218.78 Typical High $363.08 | Professional | None | $33.11 | $218.78 | $363.08 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $660.69 Typical High $1,513.56 | Facility | None | $229.09 | $660.69 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $389.05 | Professional | None | $208.93 | $275.42 | $389.05 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $2,630.27 | Facility | None | $346.74 | $707.95 | $2,630.27 |
United Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $416.87 | Professional | None | $199.53 | $288.40 | $416.87 |
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 $93.33 Median $131.83 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $52.48 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $141.25 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $28.18 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.30 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $186.21 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $131.83 | $186.21 | $245.47 |
Where New Mexico sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 30th of 51
$282
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.