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 $588.84 Median $1,380.38 Typical High $7,762.47 | Facility | None | $588.84 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $891.25 | Professional | None | $588.84 | $724.44 | $891.25 |
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 $389.05 Median $724.44 Typical High $1,047.13 | Professional | None | $389.05 | $724.44 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,348.96 Typical High $1,819.70 | Facility | None | $776.25 | $1,348.96 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,258.93 | Professional | None | $645.65 | $977.24 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $645.65 Typical High $1,096.48 | Professional | None | $33.11 | $645.65 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $1,949.84 | Facility | None | $645.65 | $1,348.96 | $1,949.84 |
Providence Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,288.25 | Professional | None | $691.83 | $1,000.00 | $1,288.25 |
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 $660.69 Median $977.24 Typical High $1,318.26 | Professional | None | $660.69 | $977.24 | $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 $295.12 Median $354.81 Typical High $446.68 | Professional | 52 · Reduced service | $295.12 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $141.25 Typical High $177.83 | Professional | 53 · Discontinued | $117.49 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $537.03 Typical High $676.08 | Professional | 54 · Surgery only | $436.52 | $537.03 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $107.15 Typical High $134.90 | Professional | 55 · Aftercare only | $89.13 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $70.79 Typical High $89.13 | Professional | 56 · Pre-op care only | $58.88 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $501.19 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $407.38 | $501.19 | $630.96 |
Where New Mexico sits
The same service costs 4.2 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· 19th of 51
$891
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.