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 $251.19 Median $1,047.13 Typical High $7,762.47 | Facility | None | $251.19 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $467.74 | Professional | None | $251.19 | $371.54 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
BCBS New Mexico Setting Facility Modifier None Typical Low $223.87 Median $1,148.15 Typical High $3,090.30 | Facility | None | $223.87 | $1,148.15 | $3,090.30 |
BCBS New Mexico Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $416.87 | Professional | None | $162.18 | $275.42 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $1,202.26 | Facility | None | $223.87 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $512.86 | Professional | None | $229.09 | $363.08 | $512.86 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $251.19 Typical High $616.60 | Professional | None | $50.12 | $251.19 | $616.60 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $380.19 Typical High $1,288.25 | Facility | None | $223.87 | $380.19 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $512.86 | Professional | None | $229.09 | $363.08 | $512.86 |
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 $323.59 Median $436.52 Typical High $575.44 | Professional | None | $323.59 | $436.52 | $575.44 |
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 $123.03 Median $186.21 Typical High $234.42 | Professional | 52 · Reduced service | $123.03 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $74.13 Typical High $93.33 | Professional | 53 · Discontinued | $50.12 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $275.42 Typical High $346.74 | Professional | 54 · Surgery only | $186.21 | $275.42 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $54.95 Typical High $70.79 | Professional | 55 · Aftercare only | $37.15 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $37.15 Typical High $46.77 | Professional | 56 · Pre-op care only | $25.12 | $37.15 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $257.04 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $173.78 | $257.04 | $323.59 |
Where New Mexico sits
The same service costs 4.2 times more in Alaska than in Utah. 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· 25th of 51
$372
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.