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 $758.58 Median $1,548.82 Typical High $8,709.64 | Facility | None | $758.58 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $977.24 | Professional | None | $676.08 | $977.24 | $977.24 |
BCBS New Mexico Setting Facility Modifier None Typical Low $4,677.35 Median $16,982.44 Typical High $25,703.96 | Facility | None | $4,677.35 | $16,982.44 | $25,703.96 |
BCBS New Mexico Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,513.56 | Professional | None | $707.95 | $891.25 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,000.00 Typical High $13,803.84 | Facility | None | $602.56 | $10,000.00 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,288.25 | Professional | None | $741.31 | $891.25 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $213.80 Typical High $1,071.52 | Professional | None | $33.11 | $213.80 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,238.72 Typical High $14,454.40 | Facility | None | $602.56 | $2,238.72 | $14,454.40 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,380.38 | Professional | None | $741.31 | $891.25 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $19,054.61 | Facility | None | $1,348.96 | $4,786.30 | $19,054.61 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,445.44 | Professional | None | $724.44 | $1,047.13 | $1,445.44 |
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 $354.81 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $354.81 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $141.25 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $537.03 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $107.15 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $70.79 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $501.19 | $676.08 | $676.08 |
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· 27th of 51
$1,047
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.