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 $1,380.38 Typical High $7,762.47 | Facility | None | $1,000.00 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $1,445.44 | Professional | None | $954.99 | $1,445.44 | $1,445.44 |
BCBS New Mexico Setting Facility Modifier None Typical Low $478.63 Median $6,606.93 Typical High $10,471.29 | Facility | None | $478.63 | $6,606.93 | $10,471.29 |
BCBS New Mexico Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,949.84 | Professional | None | $954.99 | $1,288.25 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $7,585.78 Typical High $10,715.19 | Facility | None | $776.25 | $7,585.78 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,230.27 | $1,819.70 |
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 $776.25 Median $1,513.56 Typical High $11,220.18 | Facility | None | $776.25 | $1,513.56 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,230.27 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $17,378.01 | Facility | None | $1,348.96 | $4,786.30 | $17,378.01 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $1,905.46 | Professional | None | $954.99 | $1,479.11 | $1,905.46 |
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 $478.63 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $478.63 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $190.55 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $724.44 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $144.54 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $95.50 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $676.08 | $1,000.00 | $1,000.00 |
Where New Mexico sits
The same service costs 6.2 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· 25th of 51
$1,445
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.