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 $269.15 Median $1,047.13 Typical High $7,762.47 | Facility | None | $269.15 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $467.74 | Professional | None | $269.15 | $338.84 | $467.74 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,511.89 Median $9,120.11 Typical High $13,803.84 | Facility | None | $2,511.89 | $9,120.11 | $13,803.84 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $426.58 Typical High $602.56 | Facility | None | $302.00 | $426.58 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $588.84 | Professional | None | $288.40 | $426.58 | $588.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $309.03 Typical High $524.81 | Professional | None | $33.11 | $309.03 | $524.81 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $436.52 Typical High $602.56 | Facility | None | $302.00 | $436.52 | $602.56 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $630.96 | Professional | None | $295.12 | $426.58 | $630.96 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $676.08 | Professional | None | $288.40 | $446.68 | $676.08 |
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 $134.90 Median $169.82 Typical High $234.42 | Professional | 52 · Reduced service | $134.90 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $67.61 Typical High $93.33 | Professional | 53 · Discontinued | $53.70 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $257.04 Typical High $354.81 | Professional | 54 · Surgery only | $199.53 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $51.29 Typical High $70.79 | Professional | 55 · Aftercare only | $39.81 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.88 Typical High $46.77 | Professional | 56 · Pre-op care only | $26.92 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $239.88 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $186.21 | $239.88 | $331.13 |
Where New Mexico sits
The same service costs 5.2 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· 25th of 51
$427
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.