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 $1,000.00 Median $1,122.02 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,122.02 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,445.44 | $1,445.44 |
BCBS New Mexico Setting Facility Modifier None Typical Low $5,370.32 Median $19,054.61 Typical High $29,512.09 | Facility | None | $5,370.32 | $19,054.61 | $29,512.09 |
BCBS New Mexico Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $1,513.56 | Professional | None | $870.96 | $1,318.26 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $7,585.78 | Facility | None | $602.56 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,258.93 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $316.23 Typical High $1,584.89 | Professional | None | $33.11 | $316.23 | $1,584.89 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $7,943.28 | Facility | None | $602.56 | $1,445.44 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,258.93 | $1,995.26 |
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 $977.24 Median $1,479.11 Typical High $1,995.26 | Professional | None | $977.24 | $1,479.11 | $1,995.26 |
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 $501.19 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $501.19 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $199.53 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $758.58 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $151.36 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $100.00 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $707.95 | $1,000.00 | $1,000.00 |
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· 24th of 51
$1,413
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.