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 $93.33 Median $1,000.00 Typical High $7,762.47 | Facility | None | $93.33 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $213.80 | Professional | None | $93.33 | $131.83 | $213.80 |
BCBS New Mexico Setting Professional Modifier None Typical Low $77.62 Median $128.82 Typical High $234.42 | Professional | None | $77.62 | $128.82 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $162.18 Typical High $602.56 | Facility | None | $134.90 | $162.18 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $295.12 | Professional | None | $112.20 | $169.82 | $295.12 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $60.26 Typical High $251.19 | Professional | None | $30.20 | $60.26 | $251.19 |
Providence Setting Facility Modifier None Typical Low $134.90 Median $190.55 Typical High $537.03 | Facility | None | $134.90 | $190.55 | $537.03 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $295.12 | Professional | None | $117.49 | $169.82 | $295.12 |
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 $102.33 Median $165.96 Typical High $309.03 | Professional | None | $102.33 | $165.96 | $309.03 |
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 $46.77 Median $57.54 Typical High $104.71 | Professional | 52 · Reduced service | $46.77 | $57.54 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.91 Typical High $42.66 | Professional | 53 · Discontinued | $18.62 | $22.91 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $85.11 Typical High $158.49 | Professional | 54 · Surgery only | $69.18 | $85.11 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.98 Typical High $31.62 | Professional | 55 · Aftercare only | $13.80 | $16.98 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.48 Typical High $21.38 | Professional | 56 · Pre-op care only | $9.33 | $11.48 | $21.38 |
Where New Mexico sits
The same service costs 3.3 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· 28th of 51
$166
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.