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 $57.54 Median $1,000.00 Typical High $7,762.47 | Facility | None | $57.54 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $158.49 | Professional | None | $57.54 | $89.13 | $158.49 |
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 $52.48 Median $87.10 Typical High $165.96 | Professional | None | $52.48 | $87.10 | $165.96 |
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 $72.44 Median $117.49 Typical High $223.87 | Professional | None | $72.44 | $117.49 | $223.87 |
Molina Setting Professional Modifier None Typical Low $22.91 Median $60.26 Typical High $190.55 | Professional | None | $22.91 | $60.26 | $190.55 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $134.90 Typical High $602.56 | Facility | None | $60.26 | $134.90 | $602.56 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $223.87 | Professional | None | $75.86 | $123.03 | $223.87 |
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 $64.57 Median $107.15 Typical High $234.42 | Professional | None | $64.57 | $107.15 | $234.42 |
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 $28.84 Median $35.48 Typical High $79.43 | Professional | 52 · Reduced service | $28.84 | $35.48 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.13 Typical High $31.62 | Professional | 53 · Discontinued | $11.48 | $14.13 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $53.70 Typical High $120.23 | Professional | 54 · Surgery only | $43.65 | $53.70 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.72 Typical High $23.99 | Professional | 55 · Aftercare only | $8.71 | $10.72 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.08 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.75 | $7.08 | $15.85 |
Where New Mexico sits
The same service costs 3.5 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· 29th of 51
$115
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.