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 $2,041.74 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,778.28 | $1,778.28 |
BCBS New Mexico Setting Facility Modifier None Typical Low $8,317.64 Median $30,199.52 Typical High $45,708.82 | Facility | None | $8,317.64 | $30,199.52 | $45,708.82 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $6,309.57 | Facility | None | $602.56 | $4,466.84 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,621.81 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $389.05 Typical High $1,949.84 | Professional | None | $33.11 | $389.05 | $1,949.84 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $6,456.54 | Facility | None | $602.56 | $1,905.46 | $6,456.54 |
Providence Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,621.81 | $2,630.27 |
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 $1,202.26 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,949.84 | $2,511.89 |
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 $645.65 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $645.65 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $257.04 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $954.99 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $190.55 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $128.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $891.25 | $1,230.27 | $1,230.27 |
Where New Mexico sits
The same service costs 17.0 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· 24th of 51
$1,950
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.