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 $1,122.02 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,584.89 | $1,584.89 |
BCBS New Mexico Setting Facility Modifier None Typical Low $5,248.07 Median $6,918.31 Typical High $50,118.72 | Facility | None | $5,248.07 | $6,918.31 | $50,118.72 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,479.11 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,623.41 Typical High $7,762.47 | Facility | None | $602.56 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,412.54 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $354.81 Typical High $1,778.28 | Professional | None | $33.11 | $354.81 | $1,778.28 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $8,128.31 | Facility | None | $602.56 | $1,737.80 | $8,128.31 |
Providence Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,412.54 | $2,238.72 |
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 $1,096.48 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,698.24 | $2,187.76 |
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 $562.34 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $562.34 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $223.87 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $831.76 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $165.96 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $112.20 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $776.25 | $1,122.02 | $1,122.02 |
Where New Mexico sits
The same service costs 8.7 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· 31st of 51
$1,514
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.