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 $831.76 Median $2,089.30 Typical High $8,709.64 | Facility | None | $831.76 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,071.52 | Professional | None | $758.58 | $1,071.52 | $1,071.52 |
BCBS New Mexico Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,513.56 | Professional | None | $707.95 | $1,000.00 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $7,943.28 Typical High $10,964.78 | Facility | None | $741.31 | $7,943.28 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,380.38 | Professional | None | $794.33 | $954.99 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $239.88 Typical High $1,202.26 | Professional | None | $33.11 | $239.88 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $11,481.54 | Facility | None | $741.31 | $3,090.30 | $11,481.54 |
Providence Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,513.56 | Professional | None | $794.33 | $954.99 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $19,054.61 | Facility | None | $1,348.96 | $4,786.30 | $19,054.61 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,513.56 | Professional | None | $724.44 | $1,122.02 | $1,513.56 |
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 $380.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $380.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $151.36 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $562.34 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $112.20 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $75.86 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $524.81 | $758.58 | $758.58 |
Where New Mexico sits
The same service costs 16.2 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· 28th 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.