How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1,047.13 Typical High $7,762.47 | Facility | None | $354.81 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $691.83 | Professional | None | $363.08 | $524.81 | $691.83 |
BCBS New Mexico Setting Professional Modifier None Typical Low $186.21 Median $398.11 Typical High $645.65 | Professional | None | $186.21 | $398.11 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $478.63 Typical High $602.56 | Facility | None | $346.74 | $478.63 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $707.95 | Professional | None | $295.12 | $446.68 | $707.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $120.23 Typical High $602.56 | Professional | None | $33.11 | $120.23 | $602.56 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $489.78 Typical High $602.56 | Facility | None | $346.74 | $489.78 | $602.56 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $645.65 | Professional | None | $302.00 | $457.09 | $645.65 |
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 $309.03 Median $467.74 Typical High $676.08 | Professional | None | $309.03 | $467.74 | $676.08 |
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 $263.03 Typical High $338.84 | Professional | 52 · Reduced service | $177.83 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $104.71 Typical High $138.04 | Professional | 53 · Discontinued | $70.79 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $398.11 Typical High $512.86 | Professional | 54 · Surgery only | $269.15 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $79.43 Typical High $102.33 | Professional | 55 · Aftercare only | $53.70 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $52.48 Typical High $69.18 | Professional | 56 · Pre-op care only | $35.48 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $371.54 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $251.19 | $371.54 | $478.63 |
Where New Mexico sits
The same service costs 5.0 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· 26th of 51
$479
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.