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 $43.65 Median $1,000.00 Typical High $7,762.47 | Facility | None | $43.65 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $74.13 Typical High $134.90 | Professional | None | $43.65 | $74.13 | $134.90 |
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 $40.74 Median $67.61 Typical High $134.90 | Professional | None | $40.74 | $67.61 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $117.49 Typical High $602.56 | Facility | None | $97.72 | $117.49 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $93.33 Typical High $190.55 | Professional | None | $48.98 | $93.33 | $190.55 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $60.26 Typical High $158.49 | Professional | None | $19.05 | $60.26 | $158.49 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $112.20 Typical High $537.03 | Facility | None | $72.44 | $112.20 | $537.03 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $190.55 | Professional | None | $52.48 | $93.33 | $190.55 |
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 $45.71 Median $81.28 Typical High $194.98 | Professional | None | $45.71 | $81.28 | $194.98 |
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 $21.88 Median $26.92 Typical High $67.61 | Professional | 52 · Reduced service | $21.88 | $26.92 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.72 Typical High $26.92 | Professional | 53 · Discontinued | $8.71 | $10.72 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $40.74 Typical High $100.00 | Professional | 54 · Surgery only | $33.11 | $40.74 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.13 Typical High $19.95 | Professional | 55 · Aftercare only | $6.61 | $8.13 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.37 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.37 | $5.37 | $13.49 |
Where New Mexico sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 36th of 51
$91.20
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.