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 $107.15 Median $107.15 Typical High $144.54 | Facility | None | $107.15 | $107.15 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $177.83 | Professional | None | $107.15 | $138.04 | $177.83 |
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 $72.44 Median $128.82 Typical High $218.78 | Professional | None | $72.44 | $128.82 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $134.90 Typical High $602.56 | Facility | None | $112.20 | $134.90 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $213.80 | Professional | None | $117.49 | $158.49 | $213.80 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $123.03 Typical High $204.17 | Professional | None | $24.55 | $123.03 | $204.17 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $154.88 Typical High $537.03 | Facility | None | $112.20 | $154.88 | $537.03 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $234.42 | Professional | None | $120.23 | $158.49 | $234.42 |
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 $114.82 Median $165.96 Typical High $239.88 | Professional | None | $114.82 | $165.96 | $239.88 |
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 $53.70 Median $69.18 Typical High $89.13 | Professional | 52 · Reduced service | $53.70 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $36.31 | Professional | 53 · Discontinued | $21.38 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $26.92 | Professional | 55 · Aftercare only | $15.85 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $17.78 |
Where New Mexico sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 27th of 51
$158
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.