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 $123.03 Median $1,047.13 Typical High $7,762.47 | Facility | None | $123.03 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $208.93 | Professional | None | $120.23 | $181.97 | $208.93 |
BCBS New Mexico Setting Facility Modifier None Typical Low $446.68 Median $1,548.82 Typical High $2,454.71 | Facility | None | $446.68 | $1,548.82 | $2,454.71 |
BCBS New Mexico Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $186.21 | Professional | None | $63.10 | $138.04 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $123.03 Typical High $602.56 | Facility | None | $102.33 | $123.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $234.42 | Professional | None | $97.72 | $151.36 | $234.42 |
Molina Setting Professional Modifier None Typical Low $22.39 Median $37.15 Typical High $186.21 | Professional | None | $22.39 | $37.15 | $186.21 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $144.54 Typical High $537.03 | Facility | None | $102.33 | $144.54 | $537.03 |
Providence Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $229.09 | Professional | None | $104.71 | $162.18 | $229.09 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $223.87 | Professional | None | $100.00 | $158.49 | $223.87 |
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 $61.66 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $61.66 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $24.55 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $91.20 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $18.20 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $12.30 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $125.89 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $85.11 | $125.89 | $144.54 |
Where New Mexico sits
The same service costs 4.4 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· 28th of 51
$155
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.