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 $69.18 Median $1,000.00 Typical High $7,762.47 | Facility | None | $69.18 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $177.83 | Professional | None | $69.18 | $112.20 | $177.83 |
BCBS New Mexico Setting Professional Modifier None Typical Low $63.10 Median $104.71 Typical High $181.97 | Professional | None | $63.10 | $104.71 | $181.97 |
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 $85.11 Median $138.04 Typical High $245.47 | Professional | None | $85.11 | $138.04 | $245.47 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $104.71 Typical High $208.93 | Professional | None | $25.12 | $104.71 | $208.93 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $162.18 Typical High $602.56 | Facility | None | $70.79 | $162.18 | $602.56 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $245.47 | Professional | None | $89.13 | $144.54 | $245.47 |
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 $77.62 Median $125.89 Typical High $257.04 | Professional | None | $77.62 | $125.89 | $257.04 |
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 $33.88 Median $41.69 Typical High $89.13 | Professional | 52 · Reduced service | $33.88 | $41.69 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.60 Typical High $35.48 | Professional | 53 · Discontinued | $13.80 | $16.60 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $63.10 Typical High $131.83 | Professional | 54 · Surgery only | $51.29 | $63.10 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.59 Typical High $26.30 | Professional | 55 · Aftercare only | $10.23 | $12.59 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.32 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.92 | $8.32 | $17.78 |
Where New Mexico sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 39th of 51
$126
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.