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 $1,548.82 Typical High $8,709.64 | Facility | None | $1,000.00 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,348.96 | $1,348.96 |
BCBS New Mexico Setting Facility Modifier None Typical Low $4,365.16 Median $15,488.17 Typical High $23,988.33 | Facility | None | $4,365.16 | $15,488.17 | $23,988.33 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,202.26 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $4,897.79 | Facility | None | $602.56 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,348.96 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $288.40 Typical High $1,445.44 | Professional | None | $33.11 | $288.40 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $5,128.61 | Facility | None | $602.56 | $1,621.81 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,348.96 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,548.82 | $2,041.74 |
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 $537.03 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $537.03 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $213.80 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $794.33 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $158.49 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $107.15 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $741.31 | $933.25 | $933.25 |
Where New Mexico sits
The same service costs 7.9 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· 25th of 51
$1,445
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.