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 $2,089.30 Typical High $8,709.64 | Facility | None | $1,000.00 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,548.82 | $1,548.82 |
BCBS New Mexico Setting Facility Modifier None Typical Low $4,365.16 Median $15,488.17 Typical High $23,988.33 | Facility | None | $4,365.16 | $15,488.17 | $23,988.33 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $4,897.79 | Facility | None | $741.31 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,288.25 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $309.03 Typical High $1,548.82 | Professional | None | $33.11 | $309.03 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $5,128.61 | Facility | None | $741.31 | $3,090.30 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,348.96 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,348.96 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,548.82 | $2,137.96 |
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 $512.86 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $512.86 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $208.93 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $776.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $154.88 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $102.33 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $724.44 | $1,096.48 | $1,096.48 |
Where New Mexico sits
The same service costs 6.2 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· 21st of 51
$1,514
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.