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 $138.04 Median $1,047.13 Typical High $7,762.47 | Facility | None | $138.04 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $323.59 | Professional | None | $128.82 | $199.53 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $218.78 | Professional | None | $114.82 | $114.82 | $218.78 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,737.80 Median $6,165.95 Typical High $9,549.93 | Facility | None | $1,737.80 | $6,165.95 | $9,549.93 |
BCBS New Mexico Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $331.13 | Professional | None | $100.00 | $165.96 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $234.42 Typical High $1,202.26 | Facility | None | $194.98 | $234.42 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $323.59 | Professional | None | $147.91 | $234.42 | $323.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $190.55 Typical High $316.23 | Professional | None | $33.11 | $190.55 | $316.23 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $1,288.25 | Facility | None | $158.49 | $257.04 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $331.13 | Professional | None | $147.91 | $234.42 | $331.13 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $5,011.87 | Facility | None | $575.44 | $1,174.90 | $5,011.87 |
United Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $363.08 | Professional | None | $147.91 | $229.09 | $363.08 |
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 $67.61 Median $93.33 Typical High $162.18 | Professional | 52 · Reduced service | $67.61 | $93.33 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $37.15 Typical High $64.57 | Professional | 53 · Discontinued | $26.92 | $37.15 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $138.04 Typical High $245.47 | Professional | 54 · Surgery only | $100.00 | $138.04 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $27.54 Typical High $48.98 | Professional | 55 · Aftercare only | $19.95 | $27.54 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $18.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $13.49 | $18.62 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $128.82 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $93.33 | $128.82 | $229.09 |
Where New Mexico sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$224
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.