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 $123.03 Median $1,047.13 Typical High $7,762.47 | Facility | None | $123.03 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $162.18 | Professional | None | $123.03 | $151.36 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
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 $60.26 Median $144.54 Typical High $181.97 | Professional | None | $60.26 | $144.54 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $123.03 Typical High $602.56 | Facility | None | $102.33 | $123.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $199.53 | Professional | None | $114.82 | $154.88 | $199.53 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $104.71 Typical High $173.78 | Professional | None | $20.89 | $104.71 | $173.78 |
Providence Setting Facility Modifier None Typical Low $107.15 Median $141.25 Typical High $537.03 | Facility | None | $107.15 | $141.25 | $537.03 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $213.80 | Professional | None | $114.82 | $158.49 | $213.80 |
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 $104.71 Median $165.96 Typical High $218.78 | Professional | None | $104.71 | $165.96 | $218.78 |
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 $61.66 Median $74.13 Typical High $75.86 | Professional | 52 · Reduced service | $61.66 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $112.20 Typical High $114.82 | Professional | 54 · Surgery only | $91.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.39 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $104.71 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $85.11 | $104.71 | $107.15 |
Where New Mexico sits
The same service costs 5.1 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· 32nd of 51
$148
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.