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 $165.96 Median $1,047.13 Typical High $7,762.47 | Facility | None | $165.96 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $331.13 | Professional | None | $165.96 | $218.78 | $331.13 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,778.28 Median $6,309.57 Typical High $9,772.37 | Facility | None | $1,778.28 | $6,309.57 | $9,772.37 |
BCBS New Mexico Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $371.54 | Professional | None | $117.49 | $199.53 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $257.04 Typical High $1,202.26 | Facility | None | $213.80 | $257.04 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $389.05 | Professional | None | $186.21 | $281.84 | $389.05 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $218.78 Typical High $363.08 | Professional | None | $33.11 | $218.78 | $363.08 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $309.03 Typical High $1,288.25 | Facility | None | $158.49 | $309.03 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $416.87 | Professional | None | $186.21 | $281.84 | $416.87 |
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 $173.78 Median $269.15 Typical High $446.68 | Professional | None | $173.78 | $269.15 | $446.68 |
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 $83.18 Median $109.65 Typical High $165.96 | Professional | 52 · Reduced service | $83.18 | $109.65 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $43.65 Typical High $66.07 | Professional | 53 · Discontinued | $33.11 | $43.65 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $165.96 Typical High $251.19 | Professional | 54 · Surgery only | $125.89 | $165.96 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $33.11 Typical High $50.12 | Professional | 55 · Aftercare only | $25.12 | $33.11 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $21.88 Typical High $33.11 | Professional | 56 · Pre-op care only | $16.60 | $21.88 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $154.88 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $117.49 | $154.88 | $234.42 |
Where New Mexico sits
The same service costs 3.7 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· 27th of 51
$269
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.