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 $199.53 Median $1,000.00 Typical High $7,762.47 | Facility | None | $199.53 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $446.68 | Professional | None | $169.82 | $263.03 | $446.68 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1,412.54 Median $5,128.61 Typical High $7,943.28 | Facility | None | $1,412.54 | $5,128.61 | $7,943.28 |
BCBS New Mexico Setting Professional Modifier None Typical Low $85.11 Median $213.80 Typical High $363.08 | Professional | None | $85.11 | $213.80 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $478.63 Typical High $602.56 | Facility | None | $338.84 | $478.63 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $436.52 | Professional | None | $147.91 | $239.88 | $436.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $257.04 Typical High $426.58 | Professional | None | $33.11 | $257.04 | $426.58 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $398.11 Typical High $602.56 | Facility | None | $173.78 | $398.11 | $602.56 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $436.52 | Professional | None | $147.91 | $239.88 | $436.52 |
United Setting Facility Modifier None Typical Low $346.74 Median $707.95 Typical High $2,630.27 | Facility | None | $346.74 | $707.95 | $2,630.27 |
United Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $467.74 | Professional | None | $154.88 | $263.03 | $467.74 |
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 $93.33 Median $131.83 Typical High $223.87 | Professional | 52 · Reduced service | $93.33 | $131.83 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $52.48 Typical High $89.13 | Professional | 53 · Discontinued | $38.02 | $52.48 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $199.53 Typical High $331.13 | Professional | 54 · Surgery only | $141.25 | $199.53 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $39.81 Typical High $67.61 | Professional | 55 · Aftercare only | $28.18 | $39.81 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.30 Typical High $44.67 | Professional | 56 · Pre-op care only | $18.62 | $26.30 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $186.21 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $131.83 | $186.21 | $309.03 |
Ambetter Setting Professional Modifier 51 · Multiple procedures + 59 · Distinct service Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 51 · Multiple procedures + 59 · Distinct service | $186.21 | $186.21 | $186.21 |
Where New Mexico sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 34th of 51
$257
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.