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 $53.70 Median $1,047.13 Typical High $7,762.47 | Facility | None | $53.70 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $147.91 | Professional | None | $74.13 | $100.00 | $147.91 |
BCBS New Mexico Setting Facility Modifier None Typical Low $380.19 Median $1,348.96 Typical High $2,089.30 | Facility | None | $380.19 | $1,348.96 | $2,089.30 |
BCBS New Mexico Setting Professional Modifier None Typical Low $66.07 Median $123.03 Typical High $162.18 | Professional | None | $66.07 | $123.03 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $138.04 Typical High $1,202.26 | Facility | None | $100.00 | $138.04 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $204.17 | Professional | None | $79.43 | $147.91 | $204.17 |
Molina Setting Professional Modifier None Typical Low $18.62 Median $93.33 Typical High $229.09 | Professional | None | $18.62 | $93.33 | $229.09 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $158.49 Typical High $1,288.25 | Facility | None | $100.00 | $158.49 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $204.17 | Professional | None | $79.43 | $147.91 | $204.17 |
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 $75.86 Median $138.04 Typical High $213.80 | Professional | None | $75.86 | $138.04 | $213.80 |
5 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 $26.92 Median $47.86 Typical High $74.13 | Professional | 52 · Reduced service | $26.92 | $47.86 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $19.05 Typical High $29.51 | Professional | 53 · Discontinued | $10.72 | $19.05 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $72.44 Typical High $109.65 | Professional | 54 · Surgery only | $39.81 | $72.44 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $14.45 Typical High $21.88 | Professional | 55 · Aftercare only | $7.94 | $14.45 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $9.55 Typical High $14.79 | Professional | 56 · Pre-op care only | $5.37 | $9.55 | $14.79 |
Where New Mexico sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 17th of 51
$138
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.