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 $147.91 Median $1,047.13 Typical High $7,762.47 | Facility | None | $147.91 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $338.84 | Professional | None | $141.25 | $218.78 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
BCBS New Mexico Setting Facility Modifier None Typical Low $281.84 Median $1,023.29 Typical High $1,548.82 | Facility | None | $281.84 | $1,023.29 | $1,548.82 |
BCBS New Mexico Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $288.40 | Professional | None | $100.00 | $169.82 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $275.42 Typical High $1,202.26 | Facility | None | $229.09 | $275.42 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $346.74 | Professional | None | $151.36 | $251.19 | $346.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $199.53 Typical High $338.84 | Professional | None | $33.11 | $199.53 | $338.84 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $275.42 Typical High $1,288.25 | Facility | None | $158.49 | $275.42 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $354.81 | Professional | None | $154.88 | $251.19 | $354.81 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $389.05 | Professional | None | $154.88 | $245.47 | $389.05 |
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 $70.79 Median $102.33 Typical High $169.82 | Professional | 52 · Reduced service | $70.79 | $102.33 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $40.74 Typical High $67.61 | Professional | 53 · Discontinued | $28.18 | $40.74 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $151.36 Typical High $251.19 | Professional | 54 · Surgery only | $107.15 | $151.36 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.20 Typical High $50.12 | Professional | 55 · Aftercare only | $21.38 | $30.20 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $33.88 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $141.25 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $100.00 | $141.25 | $234.42 |
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· 30th of 51
$229
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.