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 $645.65 Median $1,548.82 Typical High $8,709.64 | Facility | None | $645.65 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,071.52 | Professional | None | $645.65 | $776.25 | $1,071.52 |
BCBS New Mexico Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $7,762.47 | Facility | None | $616.60 | $1,621.81 | $7,762.47 |
BCBS New Mexico Setting Professional Modifier None Typical Low $389.05 Median $794.33 Typical High $1,023.29 | Professional | None | $389.05 | $794.33 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $2,290.87 | Facility | None | $602.56 | $1,513.56 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,258.93 | Professional | None | $707.95 | $1,047.13 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $660.69 Typical High $1,096.48 | Professional | None | $33.11 | $660.69 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $2,290.87 | Facility | None | $602.56 | $1,479.11 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,318.26 | Professional | None | $776.25 | $1,071.52 | $1,318.26 |
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 $676.08 Median $1,047.13 Typical High $1,318.26 | Professional | None | $676.08 | $1,047.13 | $1,318.26 |
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 $323.59 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $323.59 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $128.82 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $478.63 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $134.90 | Professional | 55 · Aftercare only | $95.50 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $64.57 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $446.68 | $537.03 | $630.96 |
Where New Mexico sits
The same service costs 4.6 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· 17th of 51
$933
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.