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 $173.78 Median $251.19 Typical High $2,137.96 | Facility | None | $173.78 | $251.19 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $245.47 | Professional | None | $144.54 | $194.98 | $245.47 |
BCBS New Mexico Setting Facility Modifier None Typical Low $831.76 Median $2,951.21 Typical High $4,570.88 | Facility | None | $831.76 | $2,951.21 | $4,570.88 |
BCBS New Mexico Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $245.47 | Professional | None | $93.33 | $177.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $181.97 Typical High $1,202.26 | Facility | None | $154.88 | $181.97 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $323.59 | Professional | None | $158.49 | $239.88 | $323.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $165.96 Typical High $275.42 | Professional | None | $33.11 | $165.96 | $275.42 |
Providence Setting Facility Modifier None Typical Low $154.88 Median $223.87 Typical High $1,288.25 | Facility | None | $154.88 | $223.87 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $323.59 | Professional | None | $158.49 | $245.47 | $323.59 |
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 $144.54 Median $229.09 Typical High $331.13 | Professional | None | $144.54 | $229.09 | $331.13 |
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 $72.44 Median $87.10 Typical High $114.82 | Professional | 52 · Reduced service | $72.44 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $34.67 Typical High $45.71 | Professional | 53 · Discontinued | $28.84 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $128.82 Typical High $173.78 | Professional | 54 · Surgery only | $107.15 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $25.70 Typical High $34.67 | Professional | 55 · Aftercare only | $21.38 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.45 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $120.23 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $100.00 | $120.23 | $162.18 |
Where New Mexico sits
The same service costs 4.0 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· 20th of 51
$229
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.