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 $912.01 Median $2,089.30 Typical High $8,709.64 | Facility | None | $912.01 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $1,174.90 | Professional | None | $812.83 | $1,174.90 | $1,174.90 |
BCBS New Mexico Setting Facility Modifier None Typical Low $6,606.93 Median $23,988.33 Typical High $36,307.81 | Facility | None | $6,606.93 | $23,988.33 | $36,307.81 |
BCBS New Mexico Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,230.27 | Professional | None | $812.83 | $1,096.48 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $5,495.41 Typical High $7,585.78 | Facility | None | $1,412.54 | $5,495.41 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,513.56 | Professional | None | $870.96 | $1,047.13 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $257.04 Typical High $1,288.25 | Professional | None | $33.11 | $257.04 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $5,495.41 Typical High $7,943.28 | Facility | None | $891.25 | $5,495.41 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,621.81 | Professional | None | $870.96 | $1,174.90 | $1,621.81 |
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 $794.33 Median $1,230.27 Typical High $1,621.81 | Professional | None | $794.33 | $1,230.27 | $1,621.81 |
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 $407.38 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $407.38 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $162.18 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $616.60 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $123.03 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $81.28 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $575.44 | $812.83 | $812.83 |
Where New Mexico sits
The same service costs 13.8 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
$1,175
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.