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 $524.81 Median $2,089.30 Typical High $8,709.64 | Facility | None | $524.81 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $812.83 | Professional | None | $537.03 | $776.25 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $2,951.21 | Facility | None | $537.03 | $1,905.46 | $2,951.21 |
BCBS New Mexico Setting Professional Modifier None Typical Low $288.40 Median $588.84 Typical High $831.76 | Professional | None | $288.40 | $588.84 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $1,202.26 | Facility | None | $338.84 | $407.38 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $794.33 Typical High $977.24 | Professional | None | $407.38 | $794.33 | $977.24 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $436.52 Typical High $1,071.52 | Professional | None | $87.10 | $436.52 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $575.44 Typical High $1,288.25 | Facility | None | $338.84 | $575.44 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $446.68 Median $812.83 Typical High $977.24 | Professional | None | $446.68 | $812.83 | $977.24 |
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 $562.34 Median $758.58 Typical High $1,023.29 | Professional | None | $562.34 | $758.58 | $1,023.29 |
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 $263.03 Median $389.05 Typical High $407.38 | Professional | 52 · Reduced service | $263.03 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $154.88 Typical High $162.18 | Professional | 53 · Discontinued | $104.71 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $588.84 Typical High $602.56 | Professional | 54 · Surgery only | $389.05 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $117.49 Typical High $120.23 | Professional | 55 · Aftercare only | $77.62 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $77.62 Typical High $81.28 | Professional | 56 · Pre-op care only | $52.48 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $549.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $363.08 | $549.54 | $562.34 |
Where New Mexico sits
The same service costs 6.2 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· 21st of 51
$724
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.