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 $371.54 Median $1,000.00 Typical High $7,762.47 | Facility | None | $371.54 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $660.69 | Professional | None | $371.54 | $467.74 | $660.69 |
BCBS New Mexico Setting Facility Modifier None Typical Low $758.58 Median $1,148.15 Typical High $3,981.07 | Facility | None | $758.58 | $1,148.15 | $3,981.07 |
BCBS New Mexico Setting Professional Modifier None Typical Low $263.03 Median $436.52 Typical High $630.96 | Professional | None | $263.03 | $436.52 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,905.46 | Facility | None | $776.25 | $1,000.00 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $794.33 | Professional | None | $416.87 | $575.44 | $794.33 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $436.52 Typical High $724.44 | Professional | None | $33.11 | $436.52 | $724.44 |
Providence Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $2,754.23 | Facility | None | $501.19 | $977.24 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $851.14 | Professional | None | $416.87 | $575.44 | $851.14 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $3,019.95 | Facility | None | $346.74 | $707.95 | $3,019.95 |
United Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $912.01 | Professional | None | $407.38 | $588.84 | $912.01 |
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 $186.21 Median $234.42 Typical High $331.13 | Professional | 52 · Reduced service | $186.21 | $234.42 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $93.33 Typical High $131.83 | Professional | 53 · Discontinued | $75.86 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $354.81 Typical High $489.78 | Professional | 54 · Surgery only | $281.84 | $354.81 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $70.79 Typical High $100.00 | Professional | 55 · Aftercare only | $56.23 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $46.77 Typical High $66.07 | Professional | 56 · Pre-op care only | $37.15 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $331.13 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $263.03 | $331.13 | $457.09 |
Where New Mexico sits
The same service costs 4.8 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
$562
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.