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 $47.86 Median $1,000.00 Typical High $7,762.47 | Facility | None | $47.86 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $81.28 Typical High $141.25 | Professional | None | $47.86 | $81.28 | $141.25 |
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 $46.77 Median $77.62 Typical High $147.91 | Professional | None | $46.77 | $77.62 | $147.91 |
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 $61.66 Median $100.00 Typical High $199.53 | Professional | None | $61.66 | $100.00 | $199.53 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $60.26 Typical High $169.82 | Professional | None | $20.42 | $60.26 | $169.82 |
Providence Setting Facility Modifier None Typical Low $57.54 Median $120.23 Typical High $602.56 | Facility | None | $57.54 | $120.23 | $602.56 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $104.71 Typical High $199.53 | Professional | None | $63.10 | $104.71 | $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 $57.54 Median $93.33 Typical High $204.17 | Professional | None | $57.54 | $93.33 | $204.17 |
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 $23.99 Median $29.51 Typical High $70.79 | Professional | 52 · Reduced service | $23.99 | $29.51 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.75 Typical High $28.18 | Professional | 53 · Discontinued | $9.55 | $11.75 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $43.65 Typical High $107.15 | Professional | 54 · Surgery only | $36.31 | $43.65 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.71 Typical High $21.38 | Professional | 55 · Aftercare only | $7.24 | $8.71 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.89 Typical High $14.13 | Professional | 56 · Pre-op care only | $4.79 | $5.89 | $14.13 |
Where New Mexico sits
The same service costs 3.4 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· 32nd of 51
$100
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.