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 $316.23 Median $1,047.13 Typical High $7,762.47 | Facility | None | $316.23 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $426.58 | Professional | None | $288.40 | $398.11 | $426.58 |
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 $177.83 Median $380.19 Typical High $501.19 | Professional | None | $177.83 | $380.19 | $501.19 |
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 $309.03 Median $398.11 Typical High $549.54 | Professional | None | $309.03 | $398.11 | $549.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $295.12 Typical High $489.78 | Professional | None | $33.11 | $295.12 | $489.78 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $288.40 Typical High $1,288.25 | Facility | None | $158.49 | $288.40 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $588.84 | Professional | None | $309.03 | $426.58 | $588.84 |
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 $275.42 Median $436.52 Typical High $602.56 | Professional | None | $275.42 | $436.52 | $602.56 |
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 $154.88 Median $199.53 Typical High $213.80 | Professional | 52 · Reduced service | $154.88 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $79.43 Typical High $85.11 | Professional | 53 · Discontinued | $61.66 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $295.12 Typical High $323.59 | Professional | 54 · Surgery only | $234.42 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $46.77 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $39.81 Typical High $42.66 | Professional | 56 · Pre-op care only | $30.90 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $275.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $218.78 | $275.42 | $302.00 |
Where New Mexico sits
The same service costs 5.9 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· 30th of 51
$380
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.