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 $44.67 Median $44.67 Typical High $64.57 | Facility | None | $44.67 | $44.67 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $58.88 Typical High $81.28 | Professional | None | $44.67 | $58.88 | $81.28 |
BCBS New Mexico Setting Professional Modifier None Typical Low $34.67 Median $58.88 Typical High $79.43 | Professional | None | $34.67 | $58.88 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $53.70 Typical High $602.56 | Facility | None | $44.67 | $53.70 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $97.72 | Professional | None | $50.12 | $70.79 | $97.72 |
Molina Setting Professional Modifier None Typical Low $11.22 Median $56.23 Typical High $93.33 | Professional | None | $11.22 | $56.23 | $93.33 |
Providence Setting Facility Modifier None Typical Low $46.77 Median $64.57 Typical High $537.03 | Facility | None | $46.77 | $64.57 | $537.03 |
Providence Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $104.71 | Professional | None | $51.29 | $70.79 | $104.71 |
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 $48.98 Median $72.44 Typical High $109.65 | Professional | None | $48.98 | $72.44 | $109.65 |
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 $22.39 Median $28.84 Typical High $40.74 | Professional | 52 · Reduced service | $22.39 | $28.84 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $11.48 Typical High $16.22 | Professional | 53 · Discontinued | $8.91 | $11.48 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.71 Typical High $12.02 | Professional | 55 · Aftercare only | $6.76 | $8.71 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.75 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.47 | $5.75 | $8.13 |
Where New Mexico sits
The same service costs 3.5 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· 26th of 51
$69.18
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.