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 $524.81 Median $1,047.13 Typical High $7,762.47 | Facility | None | $524.81 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $831.76 | Professional | None | $524.81 | $776.25 | $831.76 |
BCBS New Mexico Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $3,235.94 | Facility | None | $588.84 | $2,137.96 | $3,235.94 |
BCBS New Mexico Setting Professional Modifier None Typical Low $295.12 Median $588.84 Typical High $741.31 | Professional | None | $295.12 | $588.84 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $1,202.26 | Facility | None | $346.74 | $416.87 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $1,047.13 Typical High $1,479.11 | Professional | None | $416.87 | $1,047.13 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $147.91 Typical High $741.31 | Professional | None | $33.11 | $147.91 | $741.31 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $602.56 Typical High $1,380.38 | Facility | None | $346.74 | $602.56 | $1,380.38 |
Providence Setting Professional Modifier None Typical Low $446.68 Median $1,122.02 Typical High $1,513.56 | Professional | None | $446.68 | $1,122.02 | $1,513.56 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $2,630.27 | Facility | None | $346.74 | $707.95 | $2,630.27 |
United Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,479.11 | Professional | None | $645.65 | $912.01 | $1,479.11 |
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 $263.03 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $263.03 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $104.71 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $389.05 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $117.49 Typical High $125.89 | Professional | 55 · Aftercare only | $77.62 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $52.48 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $549.54 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $363.08 | $549.54 | $575.44 |
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· 19th of 51
$832
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.