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 $245.47 Median $1,380.38 Typical High $7,762.47 | Facility | None | $245.47 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $588.84 | Professional | None | $245.47 | $371.54 | $588.84 |
BCBS New Mexico Setting Facility Modifier None Typical Low $269.15 Median $354.81 Typical High $50,118.72 | Facility | None | $269.15 | $354.81 | $50,118.72 |
BCBS New Mexico Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $489.78 | Professional | None | $194.98 | $331.13 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $398.11 Typical High $2,290.87 | Facility | None | $281.84 | $398.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $616.60 | Professional | None | $257.04 | $389.05 | $616.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $102.33 Typical High $512.86 | Professional | None | $33.11 | $102.33 | $512.86 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $3,090.30 | Facility | None | $295.12 | $489.78 | $3,090.30 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $616.60 | Professional | None | $275.42 | $398.11 | $616.60 |
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 $251.19 Median $389.05 Typical High $616.60 | Professional | None | $251.19 | $389.05 | $616.60 |
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 $123.03 Median $186.21 Typical High $288.40 | Professional | 52 · Reduced service | $123.03 | $186.21 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $74.13 Typical High $117.49 | Professional | 53 · Discontinued | $50.12 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $281.84 Typical High $436.52 | Professional | 54 · Surgery only | $186.21 | $281.84 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $56.23 Typical High $87.10 | Professional | 55 · Aftercare only | $37.15 | $56.23 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $37.15 Typical High $58.88 | Professional | 56 · Pre-op care only | $24.55 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $263.03 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $173.78 | $263.03 | $407.38 |
Where New Mexico sits
The same service costs 3.9 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· 25th of 51
$389
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.