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 $691.83 Median $2,041.74 Typical High $7,762.47 | Facility | None | $691.83 | $2,041.74 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | None | $691.83 | $851.14 | $851.14 |
BCBS New Mexico Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,412.54 | Professional | None | $676.08 | $977.24 | $1,412.54 |
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 $645.65 Median $870.96 Typical High $1,230.27 | Professional | None | $645.65 | $870.96 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $190.55 Typical High $954.99 | Professional | None | $33.11 | $190.55 | $954.99 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $2,754.23 Typical High $5,128.61 | Facility | None | $537.03 | $2,754.23 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,288.25 | Professional | None | $707.95 | $870.96 | $1,288.25 |
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 $645.65 Median $933.25 Typical High $1,318.26 | Professional | None | $645.65 | $933.25 | $1,318.26 |
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 $346.74 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $346.74 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $602.56 |
Where New Mexico sits
The same service costs 8.1 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
$933
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.