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 $234.42 Median $549.54 Typical High $2,137.96 | Facility | None | $234.42 | $549.54 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $363.08 | Professional | None | $190.55 | $281.84 | $363.08 |
BCBS New Mexico Setting Facility Modifier None Typical Low $213.80 Median $489.78 Typical High $758.58 | Facility | None | $213.80 | $489.78 | $758.58 |
BCBS New Mexico Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $407.38 | Professional | None | $134.90 | $239.88 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $288.40 Typical High $602.56 | Facility | None | $239.88 | $288.40 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $512.86 | Professional | None | $234.42 | $338.84 | $512.86 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $93.33 Typical High $436.52 | Professional | None | $33.11 | $93.33 | $436.52 |
Providence Setting Facility Modifier None Typical Low $239.88 Median $338.84 Typical High $537.03 | Facility | None | $239.88 | $338.84 | $537.03 |
Providence Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $512.86 | Professional | None | $245.47 | $338.84 | $512.86 |
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 $213.80 Median $338.84 Typical High $524.81 | Professional | None | $213.80 | $338.84 | $524.81 |
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 $95.50 Median $117.49 Typical High $181.97 | Professional | 52 · Reduced service | $95.50 | $117.49 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $74.13 | Professional | 53 · Discontinued | $38.02 | $46.77 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $173.78 Typical High $275.42 | Professional | 54 · Surgery only | $144.54 | $173.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $34.67 Typical High $54.95 | Professional | 55 · Aftercare only | $28.84 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $36.31 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $162.18 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $134.90 | $162.18 | $257.04 |
Where New Mexico sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 19th of 51
$331
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.