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 $218.78 Median $1,380.38 Typical High $7,762.47 | Facility | None | $218.78 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $1,023.29 Typical High $1,737.80 | Professional | None | $218.78 | $1,023.29 | $1,737.80 |
BCBS New Mexico Setting Facility Modifier None Typical Low $3,162.28 Median $11,220.18 Typical High $17,378.01 | Facility | None | $3,162.28 | $11,220.18 | $17,378.01 |
BCBS New Mexico Setting Professional Modifier None Typical Low $245.47 Median $794.33 Typical High $1,584.89 | Professional | None | $245.47 | $794.33 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $1,659.59 | Professional | None | $239.88 | $371.54 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $794.33 Typical High $1,318.26 | Professional | None | $33.11 | $794.33 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $1,905.46 | Professional | None | $251.19 | $407.38 | $1,905.46 |
United Setting Facility Modifier None Typical Low $794.33 Median $7,762.47 Typical High $15,848.93 | Facility | None | $794.33 | $7,762.47 | $15,848.93 |
United Setting Professional Modifier None Typical Low $223.87 Median $977.24 Typical High $2,041.74 | Professional | None | $223.87 | $977.24 | $2,041.74 |
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 $109.65 Median $512.86 Typical High $870.96 | Professional | 52 · Reduced service | $109.65 | $512.86 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $204.17 Typical High $346.74 | Professional | 53 · Discontinued | $43.65 | $204.17 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $776.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $165.96 | $776.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $154.88 Typical High $263.03 | Professional | 55 · Aftercare only | $33.11 | $154.88 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $102.33 Typical High $173.78 | Professional | 56 · Pre-op care only | $21.88 | $102.33 | $173.78 |
Where New Mexico sits
The same service costs 5.9 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· 40th of 51
$794
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.