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 $123.03 Median $1,047.13 Typical High $7,762.47 | Facility | None | $123.03 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $229.09 | Professional | None | $123.03 | $181.97 | $229.09 |
BCBS New Mexico Setting Facility Modifier None Typical Low $323.59 Median $1,174.90 Typical High $1,778.28 | Facility | None | $323.59 | $1,174.90 | $1,778.28 |
BCBS New Mexico Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $194.98 | Professional | None | $75.86 | $138.04 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $134.90 Typical High $602.56 | Facility | None | $112.20 | $134.90 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $251.19 | Professional | None | $109.65 | $165.96 | $251.19 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $120.23 Typical High $302.00 | Professional | None | $23.99 | $120.23 | $302.00 |
Providence Setting Facility Modifier None Typical Low $114.82 Median $162.18 Typical High $537.03 | Facility | None | $114.82 | $162.18 | $537.03 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $251.19 | Professional | None | $114.82 | $169.82 | $251.19 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $251.19 | Professional | None | $117.49 | $169.82 | $251.19 |
7 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 $61.66 Median $91.20 Typical High $114.82 | Professional | 52 · Reduced service | $61.66 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $24.55 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $138.04 Typical High $173.78 | Professional | 54 · Surgery only | $93.33 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $27.54 Typical High $34.67 | Professional | 55 · Aftercare only | $18.62 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.30 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $128.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $87.10 | $128.82 | $162.18 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 50 · Both sides | $208.93 | $208.93 | $208.93 |
Where New Mexico sits
The same service costs 4.1 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· 26th of 51
$170
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.