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 $117.49 Median $1,047.13 Typical High $7,762.47 | Facility | None | $117.49 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $275.42 | Professional | None | $117.49 | $173.78 | $275.42 |
BCBS New Mexico Setting Facility Modifier None Typical Low $398.11 Median $1,445.44 Typical High $2,344.23 | Facility | None | $398.11 | $1,445.44 | $2,344.23 |
BCBS New Mexico Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $245.47 | Professional | None | $87.10 | $144.54 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,445.44 Typical High $2,041.74 | Facility | None | $537.03 | $1,445.44 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $275.42 | Professional | None | $120.23 | $173.78 | $275.42 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $48.98 Typical High $245.47 | Professional | None | $29.51 | $48.98 | $245.47 |
Providence Setting Facility Modifier None Typical Low $134.90 Median $1,288.25 Typical High $2,089.30 | Facility | None | $134.90 | $1,288.25 | $2,089.30 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $275.42 | Professional | None | $120.23 | $173.78 | $275.42 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $275.42 | Professional | None | $109.65 | $177.83 | $275.42 |
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 $58.88 Median $87.10 Typical High $138.04 | Professional | 52 · Reduced service | $58.88 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $54.95 | Professional | 53 · Discontinued | $23.44 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $208.93 | Professional | 54 · Surgery only | $87.10 | $128.82 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.70 Typical High $41.69 | Professional | 55 · Aftercare only | $17.38 | $25.70 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $194.98 |
Where New Mexico sits
The same service costs 4.8 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· 22nd of 51
$195
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.