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 $154.88 Median $1,047.13 Typical High $7,762.47 | Facility | None | $154.88 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $245.47 | Professional | None | $154.88 | $229.09 | $245.47 |
BCBS New Mexico Setting Facility Modifier None Typical Low $102.33 Median $134.90 Typical High $50,118.72 | Facility | None | $102.33 | $134.90 | $50,118.72 |
BCBS New Mexico Setting Professional Modifier None Typical Low $81.28 Median $173.78 Typical High $223.87 | Professional | None | $81.28 | $173.78 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $151.36 Typical High $1,202.26 | Facility | None | $109.65 | $151.36 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $275.42 | Professional | None | $123.03 | $199.53 | $275.42 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $43.65 Typical High $218.78 | Professional | None | $26.30 | $43.65 | $218.78 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $199.53 Typical High $1,288.25 | Facility | None | $112.20 | $199.53 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $275.42 | Professional | None | $134.90 | $204.17 | $275.42 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $269.15 | Professional | None | $125.89 | $208.93 | $269.15 |
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 $77.62 Median $114.82 Typical High $123.03 | Professional | 52 · Reduced service | $77.62 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $46.77 Typical High $48.98 | Professional | 53 · Discontinued | $31.62 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $173.78 Typical High $181.97 | Professional | 54 · Surgery only | $117.49 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $34.67 Typical High $36.31 | Professional | 55 · Aftercare only | $23.44 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.91 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.49 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $162.18 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $109.65 | $162.18 | $169.82 |
Where New Mexico sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 31st of 51
$186
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.