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 $1,000.00 Median $1,778.28 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,778.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,737.80 | $2,344.23 | $2,344.23 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,884.03 Median $10,232.93 Typical High $15,848.93 | Facility | None | $2,884.03 | $10,232.93 | $15,848.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $1,778.28 | Facility | None | $602.56 | $1,174.90 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,862.09 | $2,238.72 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $512.86 Typical High $2,570.40 | Professional | None | $33.11 | $512.86 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $3,388.44 | Facility | None | $602.56 | $1,479.11 | $3,388.44 |
Providence Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,238.72 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,413.10 | Facility | None | $1,047.13 | $2,344.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,570.40 | $3,467.37 |
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 $870.96 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $870.96 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $346.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,318.26 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $263.03 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $173.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,621.81 | $1,621.81 |
Where New Mexico sits
The same service costs 21.4 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· 24th of 51
$2,399
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.