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 $147.91 Median $1,047.13 Typical High $7,762.47 | Facility | None | $147.91 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $302.00 Typical High $446.68 | Professional | None | $147.91 | $302.00 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
BCBS New Mexico Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $8,912.51 | Facility | None | $398.11 | $1,148.15 | $8,912.51 |
BCBS New Mexico Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $446.68 | Professional | None | $173.78 | $346.74 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $1,288.25 | Facility | None | $537.03 | $891.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $338.84 Typical High $588.84 | Professional | None | $165.96 | $338.84 | $588.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $295.12 Typical High $489.78 | Professional | None | $33.11 | $295.12 | $489.78 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $891.25 Typical High $1,445.44 | Facility | None | $158.49 | $891.25 | $1,445.44 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $363.08 Typical High $588.84 | Professional | None | $165.96 | $363.08 | $588.84 |
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 $162.18 Median $323.59 Typical High $630.96 | Professional | None | $162.18 | $323.59 | $630.96 |
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 $74.13 Median $109.65 Typical High $223.87 | Professional | 52 · Reduced service | $74.13 | $109.65 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $44.67 Typical High $91.20 | Professional | 53 · Discontinued | $29.51 | $44.67 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $165.96 Typical High $338.84 | Professional | 54 · Surgery only | $109.65 | $165.96 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $33.11 Typical High $67.61 | Professional | 55 · Aftercare only | $21.88 | $33.11 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $21.88 Typical High $44.67 | Professional | 56 · Pre-op care only | $14.79 | $21.88 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $154.88 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $102.33 | $154.88 | $316.23 |
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· 26th of 51
$347
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.