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 $794.33 Median $1,548.82 Typical High $8,709.64 | Facility | None | $794.33 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,148.15 | Professional | None | $794.33 | $954.99 | $1,148.15 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,621.81 Median $5,888.44 Typical High $8,912.51 | Facility | None | $1,621.81 | $5,888.44 | $8,912.51 |
BCBS New Mexico Setting Professional Modifier None Typical Low $537.03 Median $977.24 Typical High $1,380.38 | Professional | None | $537.03 | $977.24 | $1,380.38 |
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 $870.96 Median $1,318.26 Typical High $1,621.81 | Professional | None | $870.96 | $1,318.26 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $851.14 Typical High $1,412.54 | Professional | None | $33.11 | $851.14 | $1,412.54 |
Providence 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 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,698.24 | Professional | None | $954.99 | $1,348.96 | $1,698.24 |
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 $891.25 Median $1,348.96 Typical High $1,737.80 | Professional | None | $891.25 | $1,348.96 | $1,737.80 |
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 $398.11 Median $478.63 Typical High $575.44 | Professional | 52 · Reduced service | $398.11 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $190.55 Typical High $229.09 | Professional | 53 · Discontinued | $158.49 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $707.95 Typical High $870.96 | Professional | 54 · Surgery only | $588.84 | $707.95 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $141.25 Typical High $173.78 | Professional | 55 · Aftercare only | $117.49 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $79.43 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $660.69 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $549.54 | $660.69 | $812.83 |
Where New Mexico sits
The same service costs 4.5 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· 20th of 51
$1,175
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.