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 $117.49 Median $117.49 Typical High $147.91 | Facility | None | $117.49 | $117.49 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $186.21 | Professional | None | $112.20 | $147.91 | $186.21 |
BCBS New Mexico Setting Facility Modifier None Typical Low $107.15 Median $380.19 Typical High $588.84 | Facility | None | $107.15 | $380.19 | $588.84 |
BCBS New Mexico Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $208.93 | Professional | None | $81.28 | $134.90 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $100.00 Typical High $602.56 | Facility | None | $83.18 | $100.00 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $223.87 | Professional | None | $123.03 | $165.96 | $223.87 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $125.89 Typical High $316.23 | Professional | None | $25.12 | $125.89 | $316.23 |
Providence Setting Facility Modifier None Typical Low $85.11 Median $131.83 Typical High $537.03 | Facility | None | $85.11 | $131.83 | $537.03 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $245.47 | Professional | None | $123.03 | $165.96 | $245.47 |
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 $123.03 Median $177.83 Typical High $251.19 | Professional | None | $123.03 | $177.83 | $251.19 |
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 $57.54 Median $74.13 Typical High $93.33 | Professional | 52 · Reduced service | $57.54 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $29.51 Typical High $37.15 | Professional | 53 · Discontinued | $23.44 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $22.39 Typical High $28.18 | Professional | 55 · Aftercare only | $17.38 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.79 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.75 | $14.79 | $18.62 |
Where New Mexico sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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
$166
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.