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 $288.40 Median $1,548.82 Typical High $8,709.64 | Facility | None | $288.40 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $398.11 | Professional | None | $288.40 | $354.81 | $398.11 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,187.76 Median $7,943.28 Typical High $12,302.69 | Facility | None | $2,187.76 | $7,943.28 | $12,302.69 |
BCBS New Mexico Setting Professional Modifier None Typical Low $169.82 Median $338.84 Typical High $467.74 | Professional | None | $169.82 | $338.84 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $1,778.28 | Facility | None | $602.56 | $1,174.90 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $549.54 | Professional | None | $302.00 | $407.38 | $549.54 |
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 $446.68 Median $1,148.15 Typical High $2,238.72 | Facility | None | $446.68 | $1,148.15 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $549.54 | Professional | None | $302.00 | $407.38 | $549.54 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,413.10 | Facility | None | $1,047.13 | $2,344.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $575.44 | Professional | None | $281.84 | $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 $144.54 Median $177.83 Typical High $199.53 | Professional | 52 · Reduced service | $144.54 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $72.44 Typical High $79.43 | Professional | 53 · Discontinued | $57.54 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $269.15 Typical High $302.00 | Professional | 54 · Surgery only | $213.80 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $53.70 Typical High $60.26 | Professional | 55 · Aftercare only | $42.66 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $35.48 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.84 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $251.19 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $199.53 | $251.19 | $281.84 |
Where New Mexico sits
The same service costs 6.8 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· 31st 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.