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 $165.96 Median $1,380.38 Typical High $7,762.47 | Facility | None | $165.96 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $446.68 | Professional | None | $165.96 | $245.47 | $446.68 |
BCBS New Mexico Setting Facility Modifier None Typical Low $234.42 Median $1,288.25 Typical High $4,365.16 | Facility | None | $234.42 | $1,288.25 | $4,365.16 |
BCBS New Mexico Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $338.84 | Professional | None | $147.91 | $245.47 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $288.40 Typical High $1,202.26 | Facility | None | $239.88 | $288.40 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $446.68 | Professional | None | $173.78 | $269.15 | $446.68 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $77.62 Typical High $389.05 | Professional | None | $33.11 | $77.62 | $389.05 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $346.74 Typical High $1,288.25 | Facility | None | $158.49 | $346.74 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $446.68 | Professional | None | $173.78 | $275.42 | $446.68 |
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 $158.49 Median $269.15 Typical High $467.74 | Professional | None | $158.49 | $269.15 | $467.74 |
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 $83.18 Median $123.03 Typical High $218.78 | Professional | 52 · Reduced service | $83.18 | $123.03 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $48.98 Typical High $89.13 | Professional | 53 · Discontinued | $33.11 | $48.98 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $186.21 Typical High $331.13 | Professional | 54 · Surgery only | $123.03 | $186.21 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $37.15 Typical High $66.07 | Professional | 55 · Aftercare only | $24.55 | $37.15 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $24.55 Typical High $44.67 | Professional | 56 · Pre-op care only | $16.60 | $24.55 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $173.78 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $114.82 | $173.78 | $309.03 |
Where New Mexico sits
The same service costs 3.8 times more in Wyoming 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· 27th 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.