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 $1,000.00 Median $1,698.24 Typical High $8,709.64 | Facility | None | $1,000.00 | $1,698.24 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,513.56 | $2,187.76 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
BCBS New Mexico Setting Facility Modifier None Typical Low $4,897.79 Median $17,782.79 Typical High $26,915.35 | Facility | None | $4,897.79 | $17,782.79 | $26,915.35 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,584.89 | $2,041.74 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,659.59 | $1,995.26 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $478.63 Typical High $2,398.83 | Professional | None | $33.11 | $478.63 | $2,398.83 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $6,165.95 | Facility | None | $602.56 | $2,511.89 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,659.59 | $1,995.26 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $16,982.44 | Facility | None | $1,995.26 | $5,495.41 | $16,982.44 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,513.56 | $2,290.87 | $3,019.95 |
4 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 54 · Surgery only Typical Low $1,148.15 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,148.15 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $229.09 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $151.36 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,548.82 | $1,548.82 |
Where New Mexico sits
The same service costs 7.8 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· 25th of 51
$2,239
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.