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 $309.03 Median $1,047.13 Typical High $7,762.47 | Facility | None | $309.03 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $446.68 | Professional | None | $281.84 | $389.05 | $446.68 |
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 $169.82 Median $371.54 Typical High $537.03 | Professional | None | $169.82 | $371.54 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $1,202.26 | Facility | None | $158.49 | $190.55 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $537.03 | Professional | None | $302.00 | $389.05 | $537.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $288.40 Typical High $478.63 | Professional | None | $33.11 | $288.40 | $478.63 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $281.84 Typical High $1,288.25 | Facility | None | $158.49 | $281.84 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $575.44 | Professional | None | $302.00 | $407.38 | $575.44 |
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 $269.15 Median $416.87 Typical High $575.44 | Professional | None | $269.15 | $416.87 | $575.44 |
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 $151.36 Median $194.98 Typical High $208.93 | Professional | 52 · Reduced service | $151.36 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $77.62 Typical High $83.18 | Professional | 53 · Discontinued | $60.26 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $295.12 Typical High $316.23 | Professional | 54 · Surgery only | $223.87 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $58.88 Typical High $63.10 | Professional | 55 · Aftercare only | $44.67 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.90 Typical High $41.69 | Professional | 56 · Pre-op care only | $30.20 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $275.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $208.93 | $275.42 | $295.12 |
Where New Mexico sits
The same service costs 5.8 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· 28th of 51
$389
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.