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 $275.42 Median $2,089.30 Typical High $8,709.64 | Facility | None | $275.42 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $363.08 | Professional | None | $257.04 | $363.08 | $363.08 |
BCBS New Mexico Setting Facility Modifier None Typical Low $3,235.94 Median $11,481.54 Typical High $17,782.79 | Facility | None | $3,235.94 | $11,481.54 | $17,782.79 |
BCBS New Mexico Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $524.81 | Professional | None | $269.15 | $331.13 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,187.76 Typical High $4,466.84 | Facility | None | $537.03 | $2,187.76 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $478.63 | Professional | None | $281.84 | $338.84 | $478.63 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $79.43 Typical High $398.11 | Professional | None | $33.11 | $79.43 | $398.11 |
Providence Setting Facility Modifier None Typical Low $316.23 Median $537.03 Typical High $4,466.84 | Facility | None | $316.23 | $537.03 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $524.81 | Professional | None | $281.84 | $338.84 | $524.81 |
United Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $1,318.26 | Facility | None | $199.53 | $245.47 | $1,318.26 |
United Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $501.19 | Professional | None | $269.15 | $389.05 | $501.19 |
5 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 $128.82 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $128.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $51.29 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $190.55 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $38.90 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.70 | $36.31 | $36.31 |
Where New Mexico sits
The same service costs 4.8 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
$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.