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 $269.15 Median $1,380.38 Typical High $7,762.47 | Facility | None | $269.15 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $457.09 | Professional | None | $269.15 | $363.08 | $457.09 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $1,174.90 Typical High $8,511.38 | Facility | None | $537.03 | $1,174.90 | $8,511.38 |
BCBS New Mexico Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $489.78 | Professional | None | $194.98 | $338.84 | $489.78 |
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 $302.00 Median $457.09 Typical High $645.65 | Professional | None | $302.00 | $457.09 | $645.65 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $331.13 Typical High $549.54 | Professional | None | $33.11 | $331.13 | $549.54 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $977.24 Typical High $1,513.56 | Facility | None | $269.15 | $977.24 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $660.69 | Professional | None | $323.59 | $467.74 | $660.69 |
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 $302.00 Median $457.09 Typical High $676.08 | Professional | None | $302.00 | $457.09 | $676.08 |
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 $134.90 Median $165.96 Typical High $229.09 | Professional | 52 · Reduced service | $134.90 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $66.07 Typical High $91.20 | Professional | 53 · Discontinued | $54.95 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $251.19 Typical High $338.84 | Professional | 54 · Surgery only | $204.17 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $50.12 Typical High $67.61 | Professional | 55 · Aftercare only | $40.74 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.11 Typical High $45.71 | Professional | 56 · Pre-op care only | $26.92 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $234.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $190.55 | $234.42 | $316.23 |
Where New Mexico sits
The same service costs 3.9 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· 21st of 51
$457
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.