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 $954.99 Median $2,089.30 Typical High $8,709.64 | Facility | None | $954.99 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,230.27 | Professional | None | $870.96 | $1,230.27 | $1,230.27 |
BCBS New Mexico Setting Facility Modifier None Typical Low $8,912.51 Median $32,359.37 Typical High $48,977.88 | Facility | None | $8,912.51 | $32,359.37 | $48,977.88 |
BCBS New Mexico Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,737.80 | Professional | None | $891.25 | $1,148.15 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $7,585.78 | Facility | None | $741.31 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,621.81 | Professional | None | $933.25 | $1,122.02 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $275.42 Typical High $1,380.38 | Professional | None | $33.11 | $275.42 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $7,943.28 | Facility | None | $741.31 | $3,090.30 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,737.80 | Professional | None | $933.25 | $1,122.02 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $16,982.44 | Facility | None | $1,995.26 | $5,495.41 | $16,982.44 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $1,737.80 | Professional | None | $870.96 | $1,318.26 | $1,737.80 |
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 $436.52 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $436.52 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $173.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $645.65 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $128.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $87.10 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $602.56 | $870.96 | $870.96 |
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· 26th of 51
$1,318
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.