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 $151.36 Median $1,380.38 Typical High $7,762.47 | Facility | None | $151.36 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $616.60 Typical High $1,047.13 | Professional | None | $151.36 | $616.60 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
BCBS New Mexico Setting Professional Modifier None Typical Low $169.82 Median $457.09 Typical High $812.83 | Professional | None | $169.82 | $457.09 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $954.99 | Professional | None | $165.96 | $275.42 | $954.99 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $478.63 Typical High $794.33 | Professional | None | $33.11 | $478.63 | $794.33 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $1,023.29 Typical High $1,023.29 | Facility | None | $151.36 | $1,023.29 | $1,023.29 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $1,096.48 | Professional | None | $173.78 | $302.00 | $1,096.48 |
United Setting Facility Modifier None Typical Low $229.09 Median $1,096.48 Typical High $1,445.44 | Facility | None | $229.09 | $1,096.48 | $1,445.44 |
United Setting Professional Modifier None Typical Low $151.36 Median $407.38 Typical High $1,122.02 | Professional | None | $151.36 | $407.38 | $1,122.02 |
5 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 $75.86 Median $309.03 Typical High $524.81 | Professional | 52 · Reduced service | $75.86 | $309.03 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $123.03 Typical High $208.93 | Professional | 53 · Discontinued | $30.20 | $123.03 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $457.09 Typical High $776.25 | Professional | 54 · Surgery only | $114.82 | $457.09 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $93.33 Typical High $158.49 | Professional | 55 · Aftercare only | $22.91 | $93.33 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $61.66 Typical High $104.71 | Professional | 56 · Pre-op care only | $15.14 | $61.66 | $104.71 |
Where New Mexico sits
The same service costs 3.8 times more in Wisconsin than in Nebraska. 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· 44th of 51
$389
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.