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 $102.33 Median $1,047.13 Typical High $7,762.47 | Facility | None | $102.33 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $144.54 | Professional | None | $97.72 | $125.89 | $144.54 |
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 $57.54 Median $123.03 Typical High $154.88 | Professional | None | $57.54 | $123.03 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $117.49 Typical High $602.56 | Facility | None | $97.72 | $117.49 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $186.21 | Professional | None | $107.15 | $144.54 | $186.21 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $100.00 Typical High $169.82 | Professional | None | $19.95 | $100.00 | $169.82 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $134.90 Typical High $537.03 | Facility | None | $102.33 | $134.90 | $537.03 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $194.98 | Professional | None | $107.15 | $144.54 | $194.98 |
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 $97.72 Median $147.91 Typical High $199.53 | Professional | None | $97.72 | $147.91 | $199.53 |
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 $51.29 Median $61.66 Typical High $70.79 | Professional | 52 · Reduced service | $51.29 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.12 Typical High $28.84 | Professional | 53 · Discontinued | $20.42 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $93.33 Typical High $107.15 | Professional | 54 · Surgery only | $75.86 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.62 Typical High $21.38 | Professional | 55 · Aftercare only | $15.14 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.59 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.23 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $87.10 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $70.79 | $87.10 | $100.00 |
Where New Mexico sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 31st of 51
$135
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.