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 $102.33 Median $1,047.13 Typical High $7,762.47 | Facility | None | $102.33 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $138.04 | Professional | None | $91.20 | $112.20 | $138.04 |
BCBS New Mexico Setting Facility Modifier None Typical Low $199.53 Median $676.08 Typical High $1,096.48 | Facility | None | $199.53 | $676.08 | $1,096.48 |
BCBS New Mexico Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $204.17 | Professional | None | $109.65 | $128.82 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $186.21 | Professional | None | $104.71 | $128.82 | $186.21 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $154.88 | Professional | None | $30.90 | $33.11 | $154.88 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $162.18 Typical High $165.96 | Facility | None | $131.83 | $162.18 | $165.96 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $208.93 | Professional | None | $109.65 | $151.36 | $208.93 |
United Setting Facility Modifier None Typical Low $229.09 Median $1,096.48 Typical High $1,949.84 | Facility | None | $229.09 | $1,096.48 | $1,949.84 |
United Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $223.87 | Professional | None | $102.33 | $154.88 | $223.87 |
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 $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $45.71 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $18.62 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $69.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $13.80 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.12 | $12.88 | $12.88 |
Where New Mexico sits
The same service costs 3.5 times more in Wisconsin than in New York. 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
$141
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.