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 $91.20 Median $281.84 Typical High $2,137.96 | Facility | None | $91.20 | $281.84 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $213.80 | Professional | None | $91.20 | $144.54 | $213.80 |
BCBS New Mexico Setting Facility Modifier None Typical Low $117.49 Median $954.99 Typical High $2,570.40 | Facility | None | $117.49 | $954.99 | $2,570.40 |
BCBS New Mexico Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $208.93 | Professional | None | $91.20 | $154.88 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $158.49 Typical High $1,202.26 | Facility | None | $117.49 | $158.49 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $316.23 | Professional | None | $147.91 | $234.42 | $316.23 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $134.90 Typical High $223.87 | Professional | None | $26.92 | $134.90 | $223.87 |
Providence Setting Facility Modifier None Typical Low $123.03 Median $169.82 Typical High $1,288.25 | Facility | None | $123.03 | $169.82 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $316.23 | Professional | None | $147.91 | $234.42 | $316.23 |
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 $151.36 Median $223.87 Typical High $323.59 | Professional | None | $151.36 | $223.87 | $323.59 |
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 $45.71 Median $45.71 Typical High $72.44 | Professional | 52 · Reduced service | $45.71 | $45.71 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $28.84 | Professional | 53 · Discontinued | $18.20 | $18.20 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $69.18 Typical High $107.15 | Professional | 54 · Surgery only | $67.61 | $69.18 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $21.38 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $64.57 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $63.10 | $64.57 | $100.00 |
Where New Mexico sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 26th of 51
$186
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.