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 $309.03 Median $1,412.54 Typical High $7,762.47 | Facility | None | $309.03 | $1,412.54 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,288.25 Typical High $2,089.30 | Professional | None | $309.03 | $1,288.25 | $2,089.30 |
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 $346.74 Median $1,174.90 Typical High $1,659.59 | Professional | None | $346.74 | $1,174.90 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $2,089.30 | Professional | None | $338.84 | $501.19 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,000.00 Typical High $1,659.59 | Professional | None | $33.11 | $1,000.00 | $1,659.59 |
Providence Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $2,344.23 | Professional | None | $338.84 | $549.54 | $2,344.23 |
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 $302.00 Median $1,202.26 Typical High $2,511.89 | Professional | None | $302.00 | $1,202.26 | $2,511.89 |
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 $154.88 Median $645.65 Typical High $1,047.13 | Professional | 52 · Reduced service | $154.88 | $645.65 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $257.04 Typical High $416.87 | Professional | 53 · Discontinued | $61.66 | $257.04 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $977.24 Typical High $1,584.89 | Professional | 54 · Surgery only | $234.42 | $977.24 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $194.98 Typical High $316.23 | Professional | 55 · Aftercare only | $46.77 | $194.98 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $128.82 Typical High $208.93 | Professional | 56 · Pre-op care only | $30.90 | $128.82 | $208.93 |
Where New Mexico sits
The same service costs 5.1 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
$1,000
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.