How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $144.54 Median $1,380.38 Typical High $7,762.47 | Facility | None | $144.54 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $426.58 | Professional | None | $144.54 | $213.80 | $426.58 |
BCBS New Mexico Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $331.13 | Professional | None | $144.54 | $229.09 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $758.58 Typical High $1,412.54 | Facility | None | $630.96 | $758.58 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $436.52 | Professional | None | $151.36 | $245.47 | $436.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $74.13 Typical High $371.54 | Professional | None | $33.11 | $74.13 | $371.54 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $741.31 Typical High $1,513.56 | Facility | None | $251.19 | $741.31 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $436.52 | Professional | None | $154.88 | $257.04 | $436.52 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,365.16 | Facility | None | $575.44 | $1,174.90 | $4,365.16 |
United Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $446.68 | Professional | None | $141.25 | $234.42 | $446.68 |
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 $72.44 Median $107.15 Typical High $208.93 | Professional | 52 · Reduced service | $72.44 | $107.15 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $42.66 Typical High $85.11 | Professional | 53 · Discontinued | $28.84 | $42.66 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $158.49 Typical High $316.23 | Professional | 54 · Surgery only | $107.15 | $158.49 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $31.62 Typical High $63.10 | Professional | 55 · Aftercare only | $21.38 | $31.62 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.38 Typical High $42.66 | Professional | 56 · Pre-op care only | $14.45 | $21.38 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $147.91 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $100.00 | $147.91 | $295.12 |
Where New Mexico sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 34th of 51
$257
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.