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 $218.78 Median $489.78 Typical High $5,011.87 | Facility | None | $218.78 | $489.78 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $309.03 | Professional | None | $177.83 | $245.47 | $309.03 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,778.28 Median $6,309.57 Typical High $9,772.37 | Facility | None | $1,778.28 | $6,309.57 | $9,772.37 |
BCBS New Mexico Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $323.59 | Professional | None | $141.25 | $234.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,479.11 | Facility | None | $776.25 | $1,000.00 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $436.52 | Professional | None | $204.17 | $309.03 | $436.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $223.87 Typical High $371.54 | Professional | None | $33.11 | $223.87 | $371.54 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $977.24 Typical High $1,513.56 | Facility | None | $245.47 | $977.24 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $446.68 | Professional | None | $208.93 | $309.03 | $446.68 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $457.09 | Professional | None | $204.17 | $309.03 | $457.09 |
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 $89.13 Median $109.65 Typical High $154.88 | Professional | 52 · Reduced service | $89.13 | $109.65 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $43.65 Typical High $61.66 | Professional | 53 · Discontinued | $35.48 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $162.18 Typical High $234.42 | Professional | 54 · Surgery only | $134.90 | $162.18 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $32.36 Typical High $46.77 | Professional | 55 · Aftercare only | $26.92 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $21.88 Typical High $30.90 | Professional | 56 · Pre-op care only | $17.78 | $21.88 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $151.36 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $125.89 | $151.36 | $218.78 |
Where New Mexico sits
The same service costs 4.2 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· 23rd of 51
$309
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.