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 $851.14 Median $1,000.00 Typical High $7,762.47 | Facility | None | $851.14 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,380.38 | Professional | None | $812.83 | $1,258.93 | $1,380.38 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,089.30 Median $7,585.78 Typical High $11,481.54 | Facility | None | $2,089.30 | $7,585.78 | $11,481.54 |
BCBS New Mexico Setting Professional Modifier None Typical Low $407.38 Median $954.99 Typical High $1,258.93 | Professional | None | $407.38 | $954.99 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $645.65 Typical High $870.96 | Facility | None | $602.56 | $645.65 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,479.11 | Professional | None | $588.84 | $1,000.00 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $245.47 Typical High $1,230.27 | Professional | None | $33.11 | $245.47 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $741.31 Typical High $1,096.48 | Facility | None | $602.56 | $741.31 | $1,096.48 |
Providence Setting Professional Modifier None Typical Low $588.84 Median $1,023.29 Typical High $1,412.54 | Professional | None | $588.84 | $1,023.29 | $1,412.54 |
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 $691.83 Median $1,071.52 Typical High $1,513.56 | Professional | None | $691.83 | $1,071.52 | $1,513.56 |
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 $426.58 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $426.58 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $251.19 Typical High $275.42 | Professional | 53 · Discontinued | $169.82 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $954.99 Typical High $1,047.13 | Professional | 54 · Surgery only | $645.65 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $128.82 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $85.11 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $891.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $602.56 | $891.25 | $977.24 |
Where New Mexico sits
The same service costs 5.4 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
$1,047
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.