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 $1,548.82 Typical High $8,709.64 | Facility | None | $1,000.00 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $1,380.38 | Professional | None | $954.99 | $1,380.38 | $1,380.38 |
BCBS New Mexico Setting Facility Modifier None Typical Low $4,897.79 Median $17,782.79 Typical High $26,915.35 | Facility | None | $4,897.79 | $17,782.79 | $26,915.35 |
BCBS New Mexico Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,949.84 | Professional | None | $977.24 | $1,288.25 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,230.27 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $302.00 Typical High $1,513.56 | Professional | None | $33.11 | $302.00 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,548.82 Typical High $6,165.95 | Facility | None | $602.56 | $1,548.82 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,230.27 | $1,949.84 |
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 $954.99 Median $1,445.44 Typical High $1,905.46 | Professional | None | $954.99 | $1,445.44 | $1,905.46 |
4 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 54 · Surgery only Typical Low $724.44 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $724.44 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $144.54 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $95.50 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $676.08 | $954.99 | $954.99 |
Where New Mexico sits
The same service costs 7.6 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
$1,413
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.