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 $354.81 Median $1,380.38 Typical High $7,762.47 | Facility | None | $354.81 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $660.69 | Professional | None | $346.74 | $478.63 | $660.69 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,511.89 Median $9,120.11 Typical High $13,803.84 | Facility | None | $2,511.89 | $9,120.11 | $13,803.84 |
BCBS New Mexico Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $645.65 | Professional | None | $229.09 | $389.05 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,467.37 Typical High $4,897.79 | Facility | None | $776.25 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $707.95 | Professional | None | $371.54 | $512.86 | $707.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $371.54 Typical High $616.60 | Professional | None | $33.11 | $371.54 | $616.60 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $1,513.56 Typical High $5,128.61 | Facility | None | $346.74 | $1,513.56 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $707.95 | Professional | None | $380.19 | $512.86 | $707.95 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $794.33 | Professional | None | $380.19 | $537.03 | $794.33 |
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 $173.78 Median $239.88 Typical High $323.59 | Professional | 52 · Reduced service | $173.78 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $95.50 Typical High $131.83 | Professional | 53 · Discontinued | $69.18 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $354.81 Typical High $489.78 | Professional | 54 · Surgery only | $257.04 | $354.81 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $70.79 Typical High $97.72 | Professional | 55 · Aftercare only | $51.29 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $47.86 Typical High $66.07 | Professional | 56 · Pre-op care only | $34.67 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $331.13 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $239.88 | $331.13 | $457.09 |
Where New Mexico sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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
$513
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.