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 $16.22 Median $16.22 Typical High $85.11 | Facility | None | $16.22 | $16.22 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $38.02 Typical High $102.33 | Professional | None | $16.22 | $38.02 | $102.33 |
BCBS New Mexico Setting Professional Modifier None Typical Low $18.62 Median $51.29 Typical High $91.20 | Professional | None | $18.62 | $51.29 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $89.13 Typical High $602.56 | Facility | None | $74.13 | $89.13 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $66.07 Typical High $112.20 | Professional | None | $17.38 | $66.07 | $112.20 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $64.57 Typical High $109.65 | Professional | None | $33.11 | $64.57 | $109.65 |
Providence Setting Facility Modifier None Typical Low $74.13 Median $89.13 Typical High $537.03 | Facility | None | $74.13 | $89.13 | $537.03 |
Providence Setting Professional Modifier None Typical Low $17.38 Median $66.07 Typical High $114.82 | Professional | None | $17.38 | $66.07 | $114.82 |
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 $18.62 Median $61.66 Typical High $131.83 | Professional | None | $18.62 | $61.66 | $131.83 |
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 $8.13 Median $11.22 Typical High $51.29 | Professional | 52 · Reduced service | $8.13 | $11.22 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $4.57 Typical High $20.42 | Professional | 53 · Discontinued | $3.31 | $4.57 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.39 Typical High $15.14 | Professional | 55 · Aftercare only | $2.45 | $3.39 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $2.29 Typical High $10.23 | Professional | 56 · Pre-op care only | $1.62 | $2.29 | $10.23 |
Where New Mexico sits
The same service costs 5.9 times more in Iowa 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· 29th of 51
$64.57
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.