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 $169.82 Typical High $208.93 | Professional | None | $114.82 | $169.82 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $151.36 | Professional | None | $107.15 | $138.04 | $151.36 |
BCBS New Mexico Setting Facility Modifier None Typical Low $89.13 Median $436.52 Typical High $1,445.44 | Facility | None | $89.13 | $436.52 | $1,445.44 |
BCBS New Mexico Setting Professional Modifier None Typical Low $79.43 Median $151.36 Typical High $234.42 | Professional | None | $79.43 | $151.36 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $123.03 Typical High $602.56 | Facility | None | $89.13 | $123.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $239.88 | Professional | None | $134.90 | $177.83 | $239.88 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $134.90 Typical High $223.87 | Professional | None | $26.92 | $134.90 | $223.87 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $123.03 Typical High $602.56 | Facility | None | $93.33 | $123.03 | $602.56 |
Providence Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $245.47 | Professional | None | $134.90 | $186.21 | $245.47 |
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 $131.83 Median $199.53 Typical High $269.15 | Professional | None | $131.83 | $199.53 | $269.15 |
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 $57.54 Median $85.11 Typical High $104.71 | Professional | 52 · Reduced service | $57.54 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $33.88 Typical High $41.69 | Professional | 53 · Discontinued | $22.91 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $158.49 | Professional | 54 · Surgery only | $87.10 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.70 Typical High $31.62 | Professional | 55 · Aftercare only | $17.38 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.98 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.48 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $147.91 |
Where New Mexico sits
The same service costs 3.9 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· 27th 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.