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 $1,380.38 Typical High $7,762.47 | Facility | None | $316.23 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $575.44 | Professional | None | $316.23 | $416.87 | $575.44 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $1,174.90 Typical High $8,511.38 | Facility | None | $537.03 | $1,174.90 | $8,511.38 |
BCBS New Mexico Setting Professional Modifier None Typical Low $234.42 Median $389.05 Typical High $602.56 | Professional | None | $234.42 | $389.05 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,479.11 | Facility | None | $776.25 | $1,000.00 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $707.95 | Professional | None | $354.81 | $501.19 | $707.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $389.05 Typical High $645.65 | Professional | None | $33.11 | $389.05 | $645.65 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $1,513.56 | Facility | None | $371.54 | $977.24 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $758.58 | Professional | None | $354.81 | $501.19 | $758.58 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $794.33 | Professional | None | $346.74 | $512.86 | $794.33 |
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 $158.49 Median $199.53 Typical High $288.40 | Professional | 52 · Reduced service | $158.49 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $81.28 Typical High $117.49 | Professional | 53 · Discontinued | $63.10 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $302.00 Typical High $436.52 | Professional | 54 · Surgery only | $239.88 | $302.00 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $60.26 Typical High $87.10 | Professional | 55 · Aftercare only | $47.86 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $40.74 Typical High $57.54 | Professional | 56 · Pre-op care only | $31.62 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $281.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $223.87 | $281.84 | $407.38 |
Where New Mexico sits
The same service costs 4.9 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· 28th of 51
$490
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.