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 $74.13 Median $1,047.13 Typical High $7,762.47 | Facility | None | $74.13 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $190.55 | Professional | None | $74.13 | $128.82 | $190.55 |
BCBS New Mexico Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $269.15 | Professional | None | $89.13 | $151.36 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $239.88 | Professional | None | $89.13 | $131.83 | $239.88 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $138.04 Typical High $229.09 | Professional | None | $27.54 | $138.04 | $229.09 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $234.42 Typical High $245.47 | Facility | None | $87.10 | $234.42 | $245.47 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $295.12 | Professional | None | $89.13 | $147.91 | $295.12 |
United Setting Facility Modifier None Typical Low $229.09 Median $1,096.48 Typical High $1,445.44 | Facility | None | $229.09 | $1,096.48 | $1,445.44 |
United Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $288.40 | Professional | None | $79.43 | $154.88 | $288.40 |
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 $37.15 Median $64.57 Typical High $95.50 | Professional | 52 · Reduced service | $37.15 | $64.57 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $25.70 Typical High $38.02 | Professional | 53 · Discontinued | $14.79 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $97.72 Typical High $144.54 | Professional | 54 · Surgery only | $54.95 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $19.50 Typical High $28.84 | Professional | 55 · Aftercare only | $10.96 | $19.50 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.88 Typical High $19.05 | Professional | 56 · Pre-op care only | $7.41 | $12.88 | $19.05 |
Where New Mexico sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 40th of 51
$145
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.