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 $177.83 Median $1,047.13 Typical High $7,762.47 | Facility | None | $177.83 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $346.74 | Professional | None | $177.83 | $234.42 | $346.74 |
BCBS New Mexico Setting Facility Modifier None Typical Low $831.76 Median $2,951.21 Typical High $4,570.88 | Facility | None | $831.76 | $2,951.21 | $4,570.88 |
BCBS New Mexico Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $398.11 | Professional | None | $128.82 | $218.78 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $1,288.25 | Facility | None | $537.03 | $891.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $407.38 | Professional | None | $199.53 | $295.12 | $407.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $229.09 Typical High $380.19 | Professional | None | $33.11 | $229.09 | $380.19 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $891.25 Typical High $1,445.44 | Facility | None | $158.49 | $891.25 | $1,445.44 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $436.52 | Professional | None | $199.53 | $295.12 | $436.52 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $3,019.95 | Facility | None | $346.74 | $707.95 | $3,019.95 |
United Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $467.74 | Professional | None | $190.55 | $288.40 | $467.74 |
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 $89.13 Median $117.49 Typical High $173.78 | Professional | 52 · Reduced service | $89.13 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $46.77 Typical High $69.18 | Professional | 53 · Discontinued | $35.48 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $173.78 Typical High $263.03 | Professional | 54 · Surgery only | $131.83 | $173.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $35.48 Typical High $52.48 | Professional | 55 · Aftercare only | $26.30 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $23.44 Typical High $34.67 | Professional | 56 · Pre-op care only | $17.78 | $23.44 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $162.18 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $123.03 | $162.18 | $245.47 |
Where New Mexico sits
The same service costs 4.1 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· 25th of 51
$295
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.