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 $123.03 Median $275.42 Typical High $2,137.96 | Facility | None | $123.03 | $275.42 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $181.97 | Professional | None | $102.33 | $154.88 | $181.97 |
BCBS New Mexico Setting Facility Modifier None Typical Low $436.52 Median $1,584.89 Typical High $2,454.71 | Facility | None | $436.52 | $1,584.89 | $2,454.71 |
BCBS New Mexico Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $186.21 | Professional | None | $72.44 | $125.89 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $1,202.26 | Facility | None | $125.89 | $158.49 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $257.04 | Professional | None | $112.20 | $173.78 | $257.04 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $131.83 Typical High $218.78 | Professional | None | $26.30 | $131.83 | $218.78 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $1,288.25 | Facility | None | $125.89 | $181.97 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $257.04 | Professional | None | $112.20 | $173.78 | $257.04 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $257.04 | Professional | None | $104.71 | $173.78 | $257.04 |
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 $51.29 Median $61.66 Typical High $91.20 | Professional | 52 · Reduced service | $51.29 | $61.66 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $24.55 Typical High $36.31 | Professional | 53 · Discontinued | $20.42 | $24.55 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $91.20 Typical High $134.90 | Professional | 54 · Surgery only | $75.86 | $91.20 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $18.62 Typical High $26.92 | Professional | 55 · Aftercare only | $15.49 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.30 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.23 | $12.30 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $85.11 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $70.79 | $85.11 | $125.89 |
Where New Mexico sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 22nd of 51
$166
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.