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 $15.85 Median $1,000.00 Typical High $7,762.47 | Facility | None | $15.85 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $19.50 Typical High $21.88 | Professional | None | $15.85 | $19.50 | $21.88 |
BCBS New Mexico Setting Facility Modifier None Typical Low $89.13 Median $316.23 Typical High $489.78 | Facility | None | $89.13 | $316.23 | $489.78 |
BCBS New Mexico Setting Professional Modifier None Typical Low $10.00 Median $19.50 Typical High $26.92 | Professional | None | $10.00 | $19.50 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Facility | None | $537.03 | $537.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $25.12 Typical High $30.90 | Professional | None | $16.98 | $25.12 | $30.90 |
Molina Setting Professional Modifier None Typical Low $3.16 Median $15.85 Typical High $33.11 | Professional | None | $3.16 | $15.85 | $33.11 |
Providence Setting Facility Modifier None Typical Low $16.98 Median $25.70 Typical High $602.56 | Facility | None | $16.98 | $25.70 | $602.56 |
Providence Setting Professional Modifier None Typical Low $19.05 Median $26.92 Typical High $31.62 | Professional | None | $19.05 | $26.92 | $31.62 |
United Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $1,318.26 | Facility | None | $199.53 | $245.47 | $1,318.26 |
United Setting Professional Modifier None Typical Low $16.60 Median $25.70 Typical High $31.62 | Professional | None | $16.60 | $25.70 | $31.62 |
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 $7.94 Median $9.77 Typical High $10.96 | Professional | 52 · Reduced service | $7.94 | $9.77 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.89 Typical High $4.37 | Professional | 53 · Discontinued | $3.16 | $3.89 | $4.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $14.79 Typical High $16.22 | Professional | 54 · Surgery only | $11.75 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.95 Typical High $3.24 | Professional | 55 · Aftercare only | $2.34 | $2.95 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.95 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.58 | $1.95 | $2.19 |
Where New Mexico sits
The same service costs 3.9 times more in Alaska than in New Jersey. 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· 24th of 51
$21.88
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.