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 $158.49 Median $1,000.00 Typical High $7,762.47 | Facility | None | $158.49 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $338.84 | Professional | None | $158.49 | $251.19 | $338.84 |
BCBS New Mexico Setting Facility Modifier None Typical Low $239.88 Median $851.14 Typical High $1,318.26 | Facility | None | $239.88 | $851.14 | $1,318.26 |
BCBS New Mexico Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $398.11 | Professional | None | $125.89 | $213.80 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $213.80 Typical High $602.56 | Facility | None | $177.83 | $213.80 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $426.58 | Professional | None | $181.97 | $269.15 | $426.58 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $234.42 Typical High $398.11 | Professional | None | $33.11 | $234.42 | $398.11 |
Providence Setting Facility Modifier None Typical Low $177.83 Median $245.47 Typical High $537.03 | Facility | None | $177.83 | $245.47 | $537.03 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $426.58 | Professional | None | $181.97 | $295.12 | $426.58 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $457.09 | Professional | None | $169.82 | $275.42 | $457.09 |
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 $79.43 Median $102.33 Typical High $169.82 | Professional | 52 · Reduced service | $79.43 | $102.33 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $40.74 Typical High $67.61 | Professional | 53 · Discontinued | $32.36 | $40.74 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $154.88 Typical High $251.19 | Professional | 54 · Surgery only | $120.23 | $154.88 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.90 Typical High $50.12 | Professional | 55 · Aftercare only | $23.99 | $30.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.42 Typical High $33.88 | Professional | 56 · Pre-op care only | $15.85 | $20.42 | $33.88 |
Where New Mexico sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 26th of 51
$263
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.