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 $851.14 Median $1,380.38 Typical High $7,762.47 | Facility | None | $851.14 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,071.52 | Professional | None | $741.31 | $1,071.52 | $1,071.52 |
BCBS New Mexico Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,513.56 | Professional | None | $676.08 | $977.24 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $2,630.27 | Facility | None | $776.25 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,258.93 | Professional | None | $758.58 | $891.25 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $234.42 Typical High $1,174.90 | Professional | None | $33.11 | $234.42 | $1,174.90 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $1,513.56 Typical High $2,754.23 | Facility | None | $741.31 | $1,513.56 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,380.38 | Professional | None | $758.58 | $933.25 | $1,380.38 |
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 $660.69 Median $1,047.13 Typical High $1,412.54 | Professional | None | $660.69 | $1,047.13 | $1,412.54 |
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 $371.54 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $371.54 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $147.91 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $562.34 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $112.20 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $74.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $524.81 | $741.31 | $741.31 |
Where New Mexico sits
The same service costs 8.3 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· 24th of 51
$1,072
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.