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 $295.12 Median $1,047.13 Typical High $7,762.47 | Facility | None | $295.12 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $398.11 | Professional | None | $275.42 | $371.54 | $398.11 |
BCBS New Mexico Setting Facility Modifier None Typical Low $154.88 Median $302.00 Typical High $977.24 | Facility | None | $154.88 | $302.00 | $977.24 |
BCBS New Mexico Setting Professional Modifier None Typical Low $162.18 Median $354.81 Typical High $501.19 | Professional | None | $162.18 | $354.81 | $501.19 |
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 $281.84 Median $363.08 Typical High $501.19 | Professional | None | $281.84 | $363.08 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $269.15 Typical High $446.68 | Professional | None | $33.11 | $269.15 | $446.68 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $251.19 Typical High $537.03 | Facility | None | $162.18 | $251.19 | $537.03 |
Providence Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $537.03 | Professional | None | $281.84 | $389.05 | $537.03 |
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 $251.19 Median $398.11 Typical High $549.54 | Professional | None | $251.19 | $398.11 | $549.54 |
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 $141.25 Median $186.21 Typical High $199.53 | Professional | 52 · Reduced service | $141.25 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $57.54 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $275.42 Typical High $295.12 | Professional | 54 · Surgery only | $213.80 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $54.95 Typical High $58.88 | Professional | 55 · Aftercare only | $42.66 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.18 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $257.04 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $199.53 | $257.04 | $275.42 |
Where New Mexico sits
The same service costs 5.8 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· 29th of 51
$363
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.