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 $169.82 Median $1,380.38 Typical High $7,762.47 | Facility | None | $169.82 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $173.78 Typical High $263.03 | Professional | None | $169.82 | $173.78 | $263.03 |
BCBS New Mexico Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $338.84 | Professional | None | $134.90 | $223.87 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $602.56 | Facility | None | $218.78 | $263.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $467.74 | Professional | None | $208.93 | $309.03 | $467.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $239.88 Typical High $407.38 | Professional | None | $33.11 | $239.88 | $407.38 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $302.00 Typical High $537.03 | Facility | None | $218.78 | $302.00 | $537.03 |
Providence Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $467.74 | Professional | None | $213.80 | $309.03 | $467.74 |
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 $213.80 Median $316.23 Typical High $501.19 | Professional | None | $213.80 | $316.23 | $501.19 |
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 $85.11 Median $87.10 Typical High $131.83 | Professional | 52 · Reduced service | $85.11 | $87.10 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $34.67 Typical High $52.48 | Professional | 53 · Discontinued | $33.88 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $128.82 Typical High $194.98 | Professional | 54 · Surgery only | $125.89 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.70 Typical High $39.81 | Professional | 55 · Aftercare only | $25.12 | $25.70 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.98 | $17.38 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $120.23 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $117.49 | $120.23 | $181.97 |
Where New Mexico sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 21st of 51
$309
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.