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 $83.18 Median $131.83 Typical High $7,762.47 | Facility | None | $83.18 | $131.83 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $131.83 | Professional | None | $83.18 | $109.65 | $131.83 |
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 $67.61 Median $114.82 Typical High $154.88 | Professional | None | $67.61 | $114.82 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $1,202.26 | Facility | None | $70.79 | $100.00 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $190.55 | Professional | None | $95.50 | $138.04 | $190.55 |
Molina Setting Professional Modifier None Typical Low $17.78 Median $89.13 Typical High $147.91 | Professional | None | $17.78 | $89.13 | $147.91 |
Providence Setting Facility Modifier None Typical Low $74.13 Median $125.89 Typical High $1,288.25 | Facility | None | $74.13 | $125.89 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $194.98 | Professional | None | $95.50 | $138.04 | $194.98 |
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 $87.10 Median $131.83 Typical High $213.80 | Professional | None | $87.10 | $131.83 | $213.80 |
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 $41.69 Median $51.29 Typical High $66.07 | Professional | 52 · Reduced service | $41.69 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $20.89 Typical High $26.92 | Professional | 53 · Discontinued | $16.60 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $77.62 Typical High $100.00 | Professional | 54 · Surgery only | $63.10 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.49 Typical High $19.95 | Professional | 55 · Aftercare only | $12.59 | $15.49 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.47 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.32 | $10.47 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $72.44 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $58.88 | $72.44 | $93.33 |
Where New Mexico sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 24th of 51
$129
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.