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 $295.12 Median $1,380.38 Typical High $7,762.47 | Facility | None | $295.12 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $1,122.02 Typical High $1,862.09 | Professional | None | $295.12 | $1,122.02 | $1,862.09 |
BCBS New Mexico Setting Professional Modifier None Typical Low $331.13 Median $891.25 Typical High $1,479.11 | Professional | None | $331.13 | $891.25 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $1,862.09 | Professional | None | $316.23 | $489.78 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $870.96 Typical High $1,445.44 | Professional | None | $33.11 | $870.96 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $1,862.09 Typical High $1,905.46 | Facility | None | $263.03 | $1,862.09 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $2,089.30 | Professional | None | $331.13 | $524.81 | $2,089.30 |
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 $288.40 Median $758.58 Typical High $2,137.96 | Professional | None | $288.40 | $758.58 | $2,137.96 |
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 $147.91 Median $562.34 Typical High $933.25 | Professional | 52 · Reduced service | $147.91 | $562.34 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $223.87 Typical High $371.54 | Professional | 53 · Discontinued | $58.88 | $223.87 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $851.14 Typical High $1,412.54 | Professional | 54 · Surgery only | $223.87 | $851.14 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $169.82 Typical High $281.84 | Professional | 55 · Aftercare only | $44.67 | $169.82 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $112.20 Typical High $186.21 | Professional | 56 · Pre-op care only | $29.51 | $112.20 | $186.21 |
Where New Mexico sits
The same service costs 3.5 times more in Wisconsin than in Maryland. 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· 42nd of 51
$708
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.