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 $112.20 Median $204.17 Typical High $5,011.87 | Facility | None | $112.20 | $204.17 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $186.21 | Professional | None | $91.20 | $128.82 | $186.21 |
BCBS New Mexico Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,862.09 | Facility | None | $109.65 | $549.54 | $1,862.09 |
BCBS New Mexico Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $213.80 | Professional | None | $83.18 | $138.04 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $151.36 Typical High $1,202.26 | Facility | None | $109.65 | $151.36 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $257.04 | Professional | None | $104.71 | $162.18 | $257.04 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $134.90 Typical High $223.87 | Professional | None | $26.92 | $134.90 | $223.87 |
Providence Setting Facility Modifier None Typical Low $114.82 Median $158.49 Typical High $1,288.25 | Facility | None | $114.82 | $158.49 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $257.04 | Professional | None | $114.82 | $173.78 | $257.04 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,365.16 | Facility | None | $575.44 | $1,174.90 | $4,365.16 |
United Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $275.42 | Professional | None | $109.65 | $173.78 | $275.42 |
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 $45.71 Median $56.23 Typical High $93.33 | Professional | 52 · Reduced service | $45.71 | $56.23 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.39 Typical High $37.15 | Professional | 53 · Discontinued | $18.20 | $22.39 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $83.18 Typical High $141.25 | Professional | 54 · Surgery only | $67.61 | $83.18 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.98 Typical High $28.18 | Professional | 55 · Aftercare only | $13.49 | $16.98 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $9.12 | $11.22 | $18.62 |
Where New Mexico sits
The same service costs 3.2 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· 25th 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.