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 $549.54 Median $2,089.30 Typical High $8,912.51 | Facility | None | $549.54 | $2,089.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $812.83 | Professional | None | $549.54 | $676.08 | $812.83 |
BCBS New Mexico Setting Professional Modifier None Typical Low $398.11 Median $660.69 Typical High $1,096.48 | Professional | None | $398.11 | $660.69 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $2,511.89 Typical High $4,365.16 | Facility | None | $1,047.13 | $2,511.89 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,174.90 | Professional | None | $602.56 | $851.14 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $537.03 Typical High $891.25 | Professional | None | $33.11 | $537.03 | $891.25 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $2,511.89 Typical High $4,365.16 | Facility | None | $645.65 | $2,511.89 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,202.26 | Professional | None | $616.60 | $851.14 | $1,202.26 |
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 $588.84 Median $891.25 Typical High $1,258.93 | Professional | None | $588.84 | $891.25 | $1,258.93 |
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 $275.42 Median $338.84 Typical High $407.38 | Professional | 52 · Reduced service | $275.42 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $134.90 Typical High $162.18 | Professional | 53 · Discontinued | $109.65 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $407.38 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $81.28 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $54.95 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $380.19 | $478.63 | $562.34 |
Where New Mexico sits
The same service costs 6.2 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· 28th of 51
$813
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.