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 $208.93 Median $1,548.82 Typical High $8,709.64 | Facility | None | $208.93 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $489.78 | Professional | None | $208.93 | $309.03 | $489.78 |
BCBS New Mexico Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $407.38 | Professional | None | $158.49 | $263.03 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $338.84 Typical High $1,202.26 | Facility | None | $281.84 | $338.84 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $537.03 | Professional | None | $213.80 | $363.08 | $537.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $87.10 Typical High $436.52 | Professional | None | $33.11 | $87.10 | $436.52 |
Providence Setting Facility Modifier None Typical Low $281.84 Median $426.58 Typical High $1,288.25 | Facility | None | $281.84 | $426.58 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $537.03 | Professional | None | $223.87 | $371.54 | $537.03 |
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 $239.88 Median $363.08 Typical High $549.54 | Professional | None | $239.88 | $363.08 | $549.54 |
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 $104.71 Median $154.88 Typical High $245.47 | Professional | 52 · Reduced service | $104.71 | $154.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $61.66 Typical High $100.00 | Professional | 53 · Discontinued | $41.69 | $61.66 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $229.09 Typical High $371.54 | Professional | 54 · Surgery only | $154.88 | $229.09 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $45.71 Typical High $74.13 | Professional | 55 · Aftercare only | $30.90 | $45.71 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.90 Typical High $48.98 | Professional | 56 · Pre-op care only | $20.89 | $30.90 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $213.80 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $144.54 | $213.80 | $346.74 |
Where New Mexico sits
The same service costs 4.3 times more in Wyoming 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· 20th of 51
$363
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.