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 $147.91 Median $1,047.13 Typical High $7,762.47 | Facility | None | $147.91 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $208.93 | Professional | None | $144.54 | $181.97 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $75.86 Median $173.78 Typical High $213.80 | Professional | None | $75.86 | $173.78 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $602.56 | Facility | None | $138.04 | $165.96 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $257.04 | Professional | None | $147.91 | $186.21 | $257.04 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $141.25 Typical High $234.42 | Professional | None | $28.18 | $141.25 | $234.42 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $190.55 Typical High $537.03 | Facility | None | $141.25 | $190.55 | $537.03 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $275.42 | Professional | None | $147.91 | $199.53 | $275.42 |
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 $131.83 Median $208.93 Typical High $281.84 | Professional | None | $131.83 | $208.93 | $281.84 |
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 $72.44 Median $91.20 Typical High $102.33 | Professional | 52 · Reduced service | $72.44 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $29.51 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $109.65 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $21.88 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.79 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $125.89 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $102.33 | $125.89 | $144.54 |
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· 32nd of 51
$182
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.