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 $19.50 Median $19.50 Typical High $34.67 | Facility | None | $19.50 | $19.50 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $28.18 Typical High $41.69 | Professional | None | $19.50 | $28.18 | $41.69 |
BCBS New Mexico Setting Professional Modifier None Typical Low $16.22 Median $26.92 Typical High $67.61 | Professional | None | $16.22 | $26.92 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $25.70 Typical High $602.56 | Facility | None | $21.38 | $25.70 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $57.54 Typical High $79.43 | Professional | None | $26.30 | $57.54 | $79.43 |
Molina Setting Professional Modifier None Typical Low $5.37 Median $26.92 Typical High $44.67 | Professional | None | $5.37 | $26.92 | $44.67 |
Providence Setting Facility Modifier None Typical Low $22.39 Median $37.15 Typical High $537.03 | Facility | None | $22.39 | $37.15 | $537.03 |
Providence Setting Professional Modifier None Typical Low $26.30 Median $57.54 Typical High $79.43 | Professional | None | $26.30 | $57.54 | $79.43 |
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 $24.55 Median $46.77 Typical High $81.28 | Professional | None | $24.55 | $46.77 | $81.28 |
4 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 $9.77 Median $13.18 Typical High $20.89 | Professional | 52 · Reduced service | $9.77 | $13.18 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $5.25 Typical High $8.32 | Professional | 53 · Discontinued | $3.89 | $5.25 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.98 Typical High $6.31 | Professional | 55 · Aftercare only | $2.95 | $3.98 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.63 Typical High $4.17 | Professional | 56 · Pre-op care only | $1.95 | $2.63 | $4.17 |
Where New Mexico sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 17th of 51
$43.65
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.