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 $70.79 Median $1,000.00 Typical High $7,762.47 | Facility | None | $70.79 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $181.97 | Professional | None | $70.79 | $104.71 | $181.97 |
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 $57.54 Median $97.72 Typical High $181.97 | Professional | None | $57.54 | $97.72 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $144.54 Typical High $602.56 | Facility | None | $120.23 | $144.54 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $257.04 | Professional | None | $83.18 | $134.90 | $257.04 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $60.26 Typical High $213.80 | Professional | None | $25.70 | $60.26 | $213.80 |
Providence Setting Facility Modifier None Typical Low $104.71 Median $151.36 Typical High $537.03 | Facility | None | $104.71 | $151.36 | $537.03 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $257.04 | Professional | None | $87.10 | $138.04 | $257.04 |
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 $128.82 Typical High $269.15 | Professional | None | $77.62 | $128.82 | $269.15 |
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 $35.48 Median $43.65 Typical High $89.13 | Professional | 52 · Reduced service | $35.48 | $43.65 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $17.38 Typical High $36.31 | Professional | 53 · Discontinued | $14.45 | $17.38 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $64.57 Typical High $134.90 | Professional | 54 · Surgery only | $53.70 | $64.57 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.18 Typical High $26.92 | Professional | 55 · Aftercare only | $10.72 | $13.18 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.71 Typical High $18.20 | Professional | 56 · Pre-op care only | $7.08 | $8.71 | $18.20 |
Where New Mexico sits
The same service costs 3.2 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· 25th of 51
$135
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.