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 $302.00 Median $588.84 Typical High $2,137.96 | Facility | None | $302.00 | $588.84 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $467.74 | Professional | None | $245.47 | $331.13 | $467.74 |
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 $141.25 Median $316.23 Typical High $457.09 | Professional | None | $141.25 | $316.23 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $602.56 | Facility | None | $158.49 | $190.55 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $446.68 | Professional | None | $251.19 | $331.13 | $446.68 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $257.04 Typical High $426.58 | Professional | None | $33.11 | $257.04 | $426.58 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $229.09 Typical High $537.03 | Facility | None | $162.18 | $229.09 | $537.03 |
Providence Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $489.78 | Professional | None | $251.19 | $338.84 | $489.78 |
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 $223.87 Median $354.81 Typical High $501.19 | Professional | None | $223.87 | $354.81 | $501.19 |
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 $125.89 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $125.89 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $251.19 Typical High $281.84 | Professional | 54 · Surgery only | $190.55 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $50.12 Typical High $56.23 | Professional | 55 · Aftercare only | $38.02 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $234.42 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $177.83 | $234.42 | $263.03 |
Where New Mexico sits
The same service costs 5.4 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· 28th of 51
$331
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.