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 $416.87 Median $478.63 Typical High $7,762.47 | Facility | None | $416.87 | $478.63 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $416.87 | Professional | None | $281.84 | $416.87 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | None | $229.09 | $251.19 | $251.19 |
BCBS New Mexico Setting Facility Modifier None Typical Low $616.60 Median $3,890.45 Typical High $12,022.64 | Facility | None | $616.60 | $3,890.45 | $12,022.64 |
BCBS New Mexico Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $489.78 | Professional | None | $263.03 | $354.81 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $4,897.79 | Facility | None | $602.56 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $478.63 | Professional | None | $302.00 | $354.81 | $478.63 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $85.11 Typical High $416.87 | Professional | None | $33.11 | $85.11 | $416.87 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $2,238.72 Typical High $5,128.61 | Facility | None | $407.38 | $2,238.72 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $501.19 | Professional | None | $316.23 | $380.19 | $501.19 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $549.54 | Professional | None | $295.12 | $407.38 | $549.54 |
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 $141.25 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $141.25 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $56.23 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $208.93 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $41.69 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.18 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $194.98 | $295.12 | $295.12 |
Where New Mexico sits
The same service costs 5.5 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· 19th of 51
$417
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.