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 $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 $1,548.82 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,548.82 | $2,238.72 | $2,238.72 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,584.89 | $2,089.30 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $7,585.78 | Facility | None | $602.56 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,698.24 | $2,041.74 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $489.78 Typical High $2,454.71 | Professional | None | $33.11 | $489.78 | $2,454.71 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $7,943.28 | Facility | None | $602.56 | $2,511.89 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,698.24 | $2,041.74 | $3,162.28 |
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 $1,548.82 Median $2,344.23 Typical High $3,090.30 | Professional | None | $1,548.82 | $2,344.23 | $3,090.30 |
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 $776.25 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $776.25 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $316.23 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,174.90 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $234.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $154.88 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,548.82 | $1,548.82 |
Where New Mexico sits
The same service costs 9.3 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· 26th of 51
$2,239
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.