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 $691.83 Median $2,089.30 Typical High $8,709.64 | Facility | None | $691.83 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | None | $616.60 | $870.96 | $870.96 |
BCBS New Mexico Setting Facility Modifier None Typical Low $3,630.78 Median $12,882.50 Typical High $19,952.62 | Facility | None | $3,630.78 | $12,882.50 | $19,952.62 |
BCBS New Mexico Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,258.93 | Professional | None | $616.60 | $812.83 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,148.15 | Professional | None | $645.65 | $776.25 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $194.98 Typical High $977.24 | Professional | None | $33.11 | $194.98 | $977.24 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $6,165.95 | Facility | None | $602.56 | $977.24 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,230.27 | Professional | None | $645.65 | $776.25 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $14,125.38 | Facility | None | $1,230.27 | $3,235.94 | $14,125.38 |
United Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,230.27 | Professional | None | $602.56 | $933.25 | $1,230.27 |
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 $309.03 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $309.03 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $123.03 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $467.74 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $93.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $61.66 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $436.52 | $616.60 | $616.60 |
Where New Mexico sits
The same service costs 7.4 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· 25th of 51
$912
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.