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 $1,380.38 Typical High $7,762.47 | Facility | None | $288.40 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $549.54 | Professional | None | $288.40 | $371.54 | $549.54 |
BCBS New Mexico Setting Facility Modifier None Typical Low $316.23 Median $3,715.35 Typical High $12,302.69 | Facility | None | $316.23 | $3,715.35 | $12,302.69 |
BCBS New Mexico Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $562.34 | Professional | None | $204.17 | $346.74 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $446.68 Typical High $602.56 | Facility | None | $316.23 | $446.68 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $645.65 | Professional | None | $316.23 | $446.68 | $645.65 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $363.08 Typical High $602.56 | Professional | None | $33.11 | $363.08 | $602.56 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $602.56 | Facility | None | $331.13 | $467.74 | $602.56 |
Providence Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $676.08 | Professional | None | $323.59 | $457.09 | $676.08 |
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 $316.23 Median $467.74 Typical High $724.44 | Professional | None | $316.23 | $467.74 | $724.44 |
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 $186.21 Typical High $275.42 | Professional | 52 · Reduced service | $144.54 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $74.13 Typical High $109.65 | Professional | 53 · Discontinued | $57.54 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $281.84 Typical High $407.38 | Professional | 54 · Surgery only | $218.78 | $281.84 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $81.28 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $37.15 Typical High $54.95 | Professional | 56 · Pre-op care only | $28.84 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $263.03 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $204.17 | $263.03 | $380.19 |
Where New Mexico sits
The same service costs 4.7 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
$437
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.