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 $398.11 Median $1,380.38 Typical High $7,762.47 | Facility | None | $398.11 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $549.54 | Professional | None | $354.81 | $549.54 | $549.54 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,398.83 Median $8,709.64 Typical High $13,489.63 | Facility | None | $2,398.83 | $8,709.64 | $13,489.63 |
BCBS New Mexico Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $645.65 | Professional | None | $302.00 | $457.09 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,659.59 Typical High $2,290.87 | Facility | None | $776.25 | $1,659.59 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $602.56 | Professional | None | $380.19 | $457.09 | $602.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $109.65 Typical High $549.54 | Professional | None | $33.11 | $109.65 | $549.54 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $1,513.56 Typical High $2,398.83 | Facility | None | $323.59 | $1,513.56 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $630.96 | Professional | None | $398.11 | $457.09 | $630.96 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $724.44 | Professional | None | $371.54 | $524.81 | $724.44 |
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 $177.83 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $177.83 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $70.79 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $269.15 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $53.70 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $35.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $251.19 | $389.05 | $389.05 |
Where New Mexico sits
The same service costs 5.1 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· 23rd of 51
$501
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.