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 $120.23 Median $1,047.13 Typical High $7,762.47 | Facility | None | $120.23 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $302.00 | Professional | None | $109.65 | $177.83 | $302.00 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2,398.83 Median $8,709.64 Typical High $13,489.63 | Facility | None | $2,398.83 | $8,709.64 | $13,489.63 |
BCBS New Mexico Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $257.04 | Professional | None | $85.11 | $141.25 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $239.88 Typical High $1,202.26 | Facility | None | $199.53 | $239.88 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $302.00 | Professional | None | $125.89 | $190.55 | $302.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $177.83 Typical High $295.12 | Professional | None | $33.11 | $177.83 | $295.12 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $229.09 Typical High $1,288.25 | Facility | None | $151.36 | $229.09 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $302.00 | Professional | None | $125.89 | $190.55 | $302.00 |
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 $123.03 Median $194.98 Typical High $309.03 | Professional | None | $123.03 | $194.98 | $309.03 |
7 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 $58.88 Median $83.18 Typical High $151.36 | Professional | 52 · Reduced service | $58.88 | $83.18 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.11 Typical High $61.66 | Professional | 53 · Discontinued | $23.44 | $33.11 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $123.03 Typical High $229.09 | Professional | 54 · Surgery only | $87.10 | $123.03 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $24.55 Typical High $45.71 | Professional | 55 · Aftercare only | $17.38 | $24.55 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.60 Typical High $30.20 | Professional | 56 · Pre-op care only | $11.75 | $16.60 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $114.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $81.28 | $114.82 | $213.80 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 59 · Distinct service | $104.71 | $104.71 | $104.71 |
Where New Mexico sits
The same service costs 3.5 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· 36th of 51
$178
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.