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 $114.82 Median $1,047.13 Typical High $7,762.47 | Facility | None | $114.82 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $181.97 | Professional | None | $114.82 | $158.49 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
BCBS New Mexico Setting Facility Modifier None Typical Low $257.04 Median $933.25 Typical High $1,412.54 | Facility | None | $257.04 | $933.25 | $1,412.54 |
BCBS New Mexico Setting Professional Modifier None Typical Low $74.13 Median $144.54 Typical High $229.09 | Professional | None | $74.13 | $144.54 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $1,202.26 | Facility | None | $100.00 | $141.25 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $269.15 | Professional | None | $134.90 | $194.98 | $269.15 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $117.49 Typical High $194.98 | Professional | None | $23.44 | $117.49 | $194.98 |
Providence Setting Facility Modifier None Typical Low $104.71 Median $173.78 Typical High $1,288.25 | Facility | None | $104.71 | $173.78 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $288.40 | Professional | None | $134.90 | $194.98 | $288.40 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,348.96 | Facility | None | $199.53 | $275.42 | $1,348.96 |
United Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $275.42 | Professional | None | $120.23 | $181.97 | $275.42 |
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 $56.23 Median $79.43 Typical High $91.20 | Professional | 52 · Reduced service | $56.23 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $31.62 Typical High $36.31 | Professional | 53 · Discontinued | $22.91 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $117.49 Typical High $134.90 | Professional | 54 · Surgery only | $85.11 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $16.98 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.85 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.48 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $109.65 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $79.43 | $109.65 | $125.89 |
Where New Mexico sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 23rd 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.