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 $245.47 Median $1,380.38 Typical High $7,762.47 | Facility | None | $245.47 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $436.52 | Professional | None | $218.78 | $323.59 | $436.52 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,511.89 Median $9,120.11 Typical High $13,803.84 | Facility | None | $2,511.89 | $9,120.11 | $13,803.84 |
BCBS New Mexico Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $446.68 | Professional | None | $158.49 | $275.42 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,412.54 | Facility | None | $758.58 | $891.25 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $467.74 | Professional | None | $257.04 | $338.84 | $467.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $257.04 Typical High $436.52 | Professional | None | $33.11 | $257.04 | $436.52 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $851.14 Typical High $1,513.56 | Facility | None | $251.19 | $851.14 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $478.63 | Professional | None | $257.04 | $338.84 | $478.63 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $524.81 | Professional | None | $257.04 | $354.81 | $524.81 |
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 $117.49 Median $162.18 Typical High $218.78 | Professional | 52 · Reduced service | $117.49 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $64.57 Typical High $87.10 | Professional | 53 · Discontinued | $46.77 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $245.47 Typical High $323.59 | Professional | 54 · Surgery only | $173.78 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $48.98 Typical High $64.57 | Professional | 55 · Aftercare only | $35.48 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $32.36 Typical High $43.65 | Professional | 56 · Pre-op care only | $23.44 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $229.09 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $162.18 | $229.09 | $302.00 |
Where New Mexico sits
The same service costs 4.3 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· 28th of 51
$339
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.