How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $363.08 Median $1,380.38 Typical High $7,762.47 | Facility | None | $363.08 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $776.25 | Professional | None | $363.08 | $562.34 | $776.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $338.84 Median $575.44 Typical High $870.96 | Professional | None | $338.84 | $575.44 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,467.37 Typical High $4,897.79 | Facility | None | $776.25 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $1,000.00 | Professional | None | $416.87 | $660.69 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $512.86 Typical High $851.14 | Professional | None | $33.11 | $512.86 | $851.14 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $1,513.56 Typical High $5,128.61 | Facility | None | $251.19 | $1,513.56 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $707.95 Typical High $1,047.13 | Professional | None | $416.87 | $707.95 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,348.96 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $1,148.15 | Professional | None | $407.38 | $645.65 | $1,148.15 |
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 $181.97 Median $281.84 Typical High $389.05 | Professional | 52 · Reduced service | $181.97 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $112.20 Typical High $154.88 | Professional | 53 · Discontinued | $72.44 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $426.58 Typical High $588.84 | Professional | 54 · Surgery only | $275.42 | $426.58 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $85.11 Typical High $117.49 | Professional | 55 · Aftercare only | $54.95 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $56.23 Typical High $77.62 | Professional | 56 · Pre-op care only | $36.31 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $398.11 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $257.04 | $398.11 | $549.54 |
Where New Mexico sits
The same service costs 4.9 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· 29th of 51
$646
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.