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 $954.99 Median $1,548.82 Typical High $8,709.64 | Facility | None | $954.99 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,202.26 | Professional | None | $831.76 | $1,202.26 | $1,202.26 |
BCBS New Mexico Setting Professional Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,659.59 | Professional | None | $676.08 | $1,096.48 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,412.54 | Professional | None | $831.76 | $1,047.13 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $263.03 Typical High $1,318.26 | Professional | None | $33.11 | $263.03 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,754.23 | Facility | None | $602.56 | $1,905.46 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,584.89 | Professional | None | $831.76 | $1,122.02 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,235.94 | $10,471.29 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $1,621.81 | Professional | None | $758.58 | $1,174.90 | $1,621.81 |
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 $416.87 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $416.87 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $165.96 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $630.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $125.89 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $83.18 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $588.84 | $851.14 | $851.14 |
Where New Mexico sits
The same service costs 7.6 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
$1,202
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.