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 $724.44 Median $2,089.30 Typical High $8,709.64 | Facility | None | $724.44 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $933.25 | Professional | None | $645.65 | $933.25 | $933.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $575.44 Median $1,318.26 Typical High $1,513.56 | Professional | None | $575.44 | $1,318.26 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,388.44 | Facility | None | $602.56 | $2,398.83 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,148.15 | Professional | None | $588.84 | $831.76 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $208.93 Typical High $1,047.13 | Professional | None | $33.11 | $208.93 | $1,047.13 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $3,467.37 | Facility | None | $602.56 | $1,071.52 | $3,467.37 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,230.27 | Professional | None | $602.56 | $831.76 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $15,848.93 | Facility | None | $1,995.26 | $5,495.41 | $15,848.93 |
United Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,318.26 | Professional | None | $630.96 | $977.24 | $1,318.26 |
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 $331.13 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $331.13 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $131.83 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $501.19 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $100.00 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $66.07 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $467.74 | $660.69 | $660.69 |
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· 26th of 51
$933
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.