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 $24.55 Median $1,047.13 Typical High $7,762.47 | Facility | None | $24.55 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $38.90 | Professional | None | $24.55 | $30.90 | $38.90 |
BCBS New Mexico Setting Facility Modifier None Typical Low $120.23 Median $436.52 Typical High $660.69 | Facility | None | $120.23 | $436.52 | $660.69 |
BCBS New Mexico Setting Professional Modifier None Typical Low $18.62 Median $30.90 Typical High $43.65 | Professional | None | $18.62 | $30.90 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $1,288.25 | Facility | None | $537.03 | $870.96 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $41.69 Typical High $53.70 | Professional | None | $26.30 | $41.69 | $53.70 |
Molina Setting Professional Modifier None Typical Low $5.62 Median $27.54 Typical High $46.77 | Professional | None | $5.62 | $27.54 | $46.77 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $1,288.25 | Facility | None | $537.03 | $870.96 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $28.18 Median $42.66 Typical High $56.23 | Professional | None | $28.18 | $42.66 | $56.23 |
United Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $1,318.26 | Facility | None | $199.53 | $245.47 | $1,318.26 |
United Setting Professional Modifier None Typical Low $29.51 Median $43.65 Typical High $58.88 | Professional | None | $29.51 | $43.65 | $58.88 |
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 $12.30 Median $15.49 Typical High $19.50 | Professional | 52 · Reduced service | $12.30 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.17 Typical High $7.76 | Professional | 53 · Discontinued | $4.90 | $6.17 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $23.44 Typical High $29.51 | Professional | 54 · Surgery only | $18.62 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.68 Typical High $5.89 | Professional | 55 · Aftercare only | $3.72 | $4.68 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.09 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.45 | $3.09 | $3.89 |
Where New Mexico sits
The same service costs 3.5 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· 23rd of 51
$38.90
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.