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 $489.78 Median $1,380.38 Typical High $7,762.47 | Facility | None | $489.78 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $933.25 | Professional | None | $489.78 | $588.84 | $933.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $309.03 Median $630.96 Typical High $1,174.90 | Professional | None | $309.03 | $630.96 | $1,174.90 |
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 $371.54 Median $630.96 Typical High $1,000.00 | Professional | None | $371.54 | $630.96 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $602.56 Typical High $1,000.00 | Professional | None | $33.11 | $602.56 | $1,000.00 |
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 $371.54 Median $630.96 Typical High $1,047.13 | Professional | None | $371.54 | $630.96 | $1,047.13 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $5,011.87 | Facility | None | $575.44 | $1,174.90 | $5,011.87 |
United Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $1,096.48 | Professional | None | $371.54 | $660.69 | $1,096.48 |
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 $245.47 Median $295.12 Typical High $467.74 | Professional | 52 · Reduced service | $245.47 | $295.12 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $117.49 Typical High $186.21 | Professional | 53 · Discontinued | $97.72 | $117.49 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $436.52 Typical High $707.95 | Professional | 54 · Surgery only | $363.08 | $436.52 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $87.10 Typical High $141.25 | Professional | 55 · Aftercare only | $72.44 | $87.10 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $58.88 Typical High $93.33 | Professional | 56 · Pre-op care only | $48.98 | $58.88 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $407.38 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $338.84 | $407.38 | $660.69 |
Where New Mexico sits
The same service costs 5.9 times more in Alaska than in Kentucky. 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· 37th of 51
$631
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.