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 $257.04 Median $1,380.38 Typical High $7,762.47 | Facility | None | $257.04 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $478.63 | Professional | None | $257.04 | $363.08 | $478.63 |
BCBS New Mexico Setting Facility Modifier None Typical Low $275.42 Median $4,786.30 Typical High $12,882.50 | Facility | None | $275.42 | $4,786.30 | $12,882.50 |
BCBS New Mexico Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $457.09 | Professional | None | $181.97 | $309.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $389.05 Typical High $602.56 | Facility | None | $275.42 | $389.05 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $588.84 | Professional | None | $288.40 | $416.87 | $588.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $323.59 Typical High $537.03 | Professional | None | $33.11 | $323.59 | $537.03 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $602.56 | Facility | None | $288.40 | $398.11 | $602.56 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $616.60 | Professional | None | $288.40 | $416.87 | $616.60 |
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 $660.69 | Professional | None | $281.84 | $416.87 | $660.69 |
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 $128.82 Median $169.82 Typical High $239.88 | Professional | 52 · Reduced service | $128.82 | $169.82 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $67.61 Typical High $95.50 | Professional | 53 · Discontinued | $51.29 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $251.19 Typical High $363.08 | Professional | 54 · Surgery only | $194.98 | $251.19 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $50.12 Typical High $72.44 | Professional | 55 · Aftercare only | $38.90 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $33.88 Typical High $47.86 | Professional | 56 · Pre-op care only | $25.70 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $234.42 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $181.97 | $234.42 | $338.84 |
Where New Mexico sits
The same service costs 4.3 times more in Alaska than in Texas. 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· 29th of 51
$398
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.