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 $302.00 Median $1,047.13 Typical High $7,762.47 | Facility | None | $302.00 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $426.58 | Professional | None | $275.42 | $371.54 | $426.58 |
BCBS New Mexico Setting Facility Modifier None Typical Low $165.96 Median $616.60 Typical High $933.25 | Facility | None | $165.96 | $616.60 | $933.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $165.96 Median $354.81 Typical High $467.74 | Professional | None | $165.96 | $354.81 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $1,202.26 | Facility | None | $158.49 | $190.55 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $512.86 | Professional | None | $295.12 | $380.19 | $512.86 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $275.42 Typical High $457.09 | Professional | None | $33.11 | $275.42 | $457.09 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $275.42 Typical High $1,288.25 | Facility | None | $158.49 | $275.42 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $549.54 | Professional | None | $295.12 | $398.11 | $549.54 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $562.34 | Professional | None | $263.03 | $407.38 | $562.34 |
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 $144.54 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $144.54 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $57.54 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $281.84 Typical High $302.00 | Professional | 54 · Surgery only | $218.78 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $60.26 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.84 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $263.03 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $204.17 | $263.03 | $281.84 |
Where New Mexico sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 27th of 51
$372
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.