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 $263.03 Median $1,047.13 Typical High $7,762.47 | Facility | None | $263.03 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $398.11 | Professional | None | $263.03 | $331.13 | $398.11 |
BCBS New Mexico Setting Facility Modifier None Typical Low $281.84 Median $1,023.29 Typical High $1,548.82 | Facility | None | $281.84 | $1,023.29 | $1,548.82 |
BCBS New Mexico Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $501.19 | Professional | None | $190.55 | $331.13 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $288.40 Typical High $1,202.26 | Facility | None | $239.88 | $288.40 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $562.34 | Professional | None | $295.12 | $436.52 | $562.34 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $190.55 Typical High $489.78 | Professional | None | $33.11 | $190.55 | $489.78 |
Providence Setting Facility Modifier None Typical Low $239.88 Median $380.19 Typical High $1,288.25 | Facility | None | $239.88 | $380.19 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $575.44 | Professional | None | $309.03 | $457.09 | $575.44 |
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 $302.00 Median $457.09 Typical High $588.84 | Professional | None | $302.00 | $457.09 | $588.84 |
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 $131.83 Median $158.49 Typical High $199.53 | Professional | 52 · Reduced service | $131.83 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $64.57 Typical High $79.43 | Professional | 53 · Discontinued | $53.70 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $239.88 Typical High $295.12 | Professional | 54 · Surgery only | $199.53 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $47.86 Typical High $58.88 | Professional | 55 · Aftercare only | $39.81 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $31.62 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.30 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $223.87 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $186.21 | $223.87 | $275.42 |
Where New Mexico sits
The same service costs 4.7 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· 17th of 51
$398
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.