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 $1,000.00 Median $2,089.30 Typical High $8,709.64 | Facility | None | $1,000.00 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,380.38 Typical High $1,380.38 | Professional | None | $933.25 | $1,380.38 | $1,380.38 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,737.80 Median $6,165.95 Typical High $9,549.93 | Facility | None | $1,737.80 | $6,165.95 | $9,549.93 |
BCBS New Mexico Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,819.70 | Professional | None | $870.96 | $1,258.93 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,187.76 Typical High $3,311.31 | Facility | None | $741.31 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,737.80 | Professional | None | $870.96 | $1,202.26 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $302.00 Typical High $1,513.56 | Professional | None | $33.11 | $302.00 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $2,137.96 Typical High $3,311.31 | Facility | None | $741.31 | $2,137.96 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,778.28 | Professional | None | $954.99 | $1,202.26 | $1,778.28 |
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 $912.01 Median $1,412.54 Typical High $1,905.46 | Professional | None | $912.01 | $1,412.54 | $1,905.46 |
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 $478.63 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $478.63 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $190.55 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $724.44 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $144.54 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $95.50 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $676.08 | $954.99 | $954.99 |
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· 22nd of 51
$1,349
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.