How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $66.07 Median $1,047.13 Typical High $7,762.47 | Facility | None | $66.07 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $100.00 | Professional | None | $66.07 | $87.10 | $100.00 |
BCBS New Mexico Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $138.04 | Professional | None | $60.26 | $89.13 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $602.56 | Facility | None | $63.10 | $89.13 | $602.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $89.13 Typical High $602.56 | Facility | None | $66.07 | $89.13 | $602.56 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $199.53 | Professional | None | $131.83 | $131.83 | $199.53 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $181.97 | Professional | None | $77.62 | $117.49 | $181.97 |
5 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 $33.11 Median $33.88 Typical High $48.98 | Professional | 52 · Reduced service | $33.11 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.49 Typical High $19.95 | Professional | 53 · Discontinued | $13.18 | $13.49 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $74.13 | Professional | 54 · Surgery only | $50.12 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $14.79 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.61 | $6.76 | $9.77 |
Where New Mexico sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 31st of 51
$112
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.