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 $363.08 Median $1,047.13 Typical High $7,762.47 | Facility | None | $363.08 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $489.78 | Professional | None | $363.08 | $457.09 | $489.78 |
BCBS New Mexico Setting Facility Modifier None Typical Low $165.96 Median $602.56 Typical High $933.25 | Facility | None | $165.96 | $602.56 | $933.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $199.53 Median $436.52 Typical High $616.60 | Professional | None | $199.53 | $436.52 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $1,202.26 | Facility | None | $158.49 | $190.55 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $616.60 | Professional | None | $354.81 | $446.68 | $616.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $338.84 Typical High $562.34 | Professional | None | $33.11 | $338.84 | $562.34 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $316.23 Typical High $1,288.25 | Facility | None | $158.49 | $316.23 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $660.69 | Professional | None | $354.81 | $478.63 | $660.69 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $676.08 | Professional | None | $316.23 | $489.78 | $676.08 |
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 $173.78 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $173.78 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $70.79 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $263.03 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $74.13 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $35.48 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $245.47 | $316.23 | $346.74 |
Where New Mexico sits
The same service costs 5.1 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
$457
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.