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 $2.04 Median $1,047.13 Typical High $7,762.47 | Facility | None | $2.04 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2.40 Median $4.90 Typical High $8.13 | Professional | None | $2.40 | $4.90 | $8.13 |
BCBS New Mexico Setting Facility Modifier None Typical Low $44.67 Median $162.18 Typical High $245.47 | Facility | None | $44.67 | $162.18 | $245.47 |
BCBS New Mexico Setting Professional Modifier None Typical Low $2.40 Median $5.13 Typical High $8.13 | Professional | None | $2.40 | $5.13 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Facility | None | $537.03 | $537.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $7.41 Typical High $10.96 | Professional | None | $2.88 | $7.41 | $10.96 |
Molina Setting Professional Modifier None Typical Low $1.10 Median $5.50 Typical High $33.11 | Professional | None | $1.10 | $5.50 | $33.11 |
Providence Setting Facility Modifier None Typical Low $9.12 Median $10.47 Typical High $602.56 | Facility | None | $9.12 | $10.47 | $602.56 |
Providence Setting Professional Modifier None Typical Low $3.24 Median $7.94 Typical High $11.48 | Professional | None | $3.24 | $7.94 | $11.48 |
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 $3.31 Median $6.92 Typical High $11.48 | Professional | None | $3.31 | $6.92 | $11.48 |
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 $1.02 Median $1.20 Typical High $3.80 | Professional | 52 · Reduced service | $1.02 | $1.20 | $3.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.48 Typical High $1.51 | Professional | 53 · Discontinued | $0.41 | $0.48 | $1.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.55 Median $1.82 Typical High $5.75 | Professional | 54 · Surgery only | $1.55 | $1.82 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.36 Typical High $1.12 | Professional | 55 · Aftercare only | $0.31 | $0.36 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.24 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.21 | $0.24 | $0.76 |
Where New Mexico sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 20th of 51
$6.92
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.