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 $208.93 Median $1,380.38 Typical High $7,762.47 | Facility | None | $208.93 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $446.68 | Professional | None | $208.93 | $316.23 | $446.68 |
BCBS New Mexico Setting Facility Modifier None Typical Low $138.04 Median $501.19 Typical High $776.25 | Facility | None | $138.04 | $501.19 | $776.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $512.86 | Professional | None | $158.49 | $263.03 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $1,412.54 | Facility | None | $257.04 | $309.03 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $630.96 | Professional | None | $251.19 | $389.05 | $630.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $107.15 Typical High $537.03 | Professional | None | $33.11 | $107.15 | $537.03 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $371.54 Typical High $1,513.56 | Facility | None | $251.19 | $371.54 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $630.96 | Professional | None | $257.04 | $398.11 | $630.96 |
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 $239.88 Median $371.54 Typical High $630.96 | Professional | None | $239.88 | $371.54 | $630.96 |
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 $104.71 Median $128.82 Typical High $223.87 | Professional | 52 · Reduced service | $104.71 | $128.82 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $52.48 Typical High $91.20 | Professional | 53 · Discontinued | $41.69 | $52.48 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $194.98 Typical High $338.84 | Professional | 54 · Surgery only | $158.49 | $194.98 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $38.90 Typical High $67.61 | Professional | 55 · Aftercare only | $31.62 | $38.90 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $25.70 Typical High $44.67 | Professional | 56 · Pre-op care only | $20.89 | $25.70 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $181.97 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $147.91 | $181.97 | $316.23 |
Where New Mexico sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 23rd of 51
$372
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.