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 $371.54 Median $1,380.38 Typical High $7,762.47 | Facility | None | $371.54 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $588.84 | Professional | None | $371.54 | $467.74 | $588.84 |
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 |
BCBS New Mexico Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $776.25 | Professional | None | $245.47 | $426.58 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,698.24 Typical High $2,398.83 | Facility | None | $776.25 | $1,698.24 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $776.25 | Professional | None | $389.05 | $562.34 | $776.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $389.05 Typical High $645.65 | Professional | None | $33.11 | $389.05 | $645.65 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $1,513.56 Typical High $2,511.89 | Facility | None | $380.19 | $1,513.56 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $831.76 | Professional | None | $398.11 | $588.84 | $831.76 |
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 $398.11 Median $602.56 Typical High $891.25 | Professional | None | $398.11 | $602.56 | $891.25 |
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 $186.21 Median $234.42 Typical High $295.12 | Professional | 52 · Reduced service | $186.21 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $93.33 Typical High $117.49 | Professional | 53 · Discontinued | $75.86 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $346.74 Typical High $446.68 | Professional | 54 · Surgery only | $281.84 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $69.18 Typical High $89.13 | Professional | 55 · Aftercare only | $56.23 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $46.77 Typical High $58.88 | Professional | 56 · Pre-op care only | $37.15 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $323.59 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $263.03 | $323.59 | $416.87 |
Where New Mexico sits
The same service costs 6.0 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· 27th of 51
$562
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.