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 $398.11 Median $2,089.30 Typical High $8,709.64 | Facility | None | $398.11 | $2,089.30 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $1,698.24 Typical High $3,467.37 | Professional | None | $354.81 | $1,698.24 | $3,467.37 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
BCBS New Mexico Setting Facility Modifier None Typical Low $5,128.61 Median $18,620.87 Typical High $28,183.83 | Facility | None | $5,128.61 | $18,620.87 | $28,183.83 |
BCBS New Mexico Setting Professional Modifier None Typical Low $457.09 Median $1,513.56 Typical High $2,884.03 | Professional | None | $457.09 | $1,513.56 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $2,818.38 | Professional | None | $398.11 | $616.60 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,659.59 Typical High $2,754.23 | Professional | None | $33.11 | $1,659.59 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $3,467.37 | Professional | None | $398.11 | $707.95 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $10,964.78 Typical High $24,547.09 | Facility | None | $1,023.29 | $10,964.78 | $24,547.09 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,778.28 Typical High $3,548.13 | Professional | None | $380.19 | $1,778.28 | $3,548.13 |
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 $194.98 Median $933.25 Typical High $1,737.80 | Professional | 52 · Reduced service | $194.98 | $933.25 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $371.54 Typical High $691.83 | Professional | 53 · Discontinued | $79.43 | $371.54 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $1,412.54 Typical High $2,570.40 | Professional | 54 · Surgery only | $295.12 | $1,412.54 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $281.84 Typical High $524.81 | Professional | 55 · Aftercare only | $58.88 | $281.84 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $186.21 Typical High $346.74 | Professional | 56 · Pre-op care only | $39.81 | $186.21 | $346.74 |
Where New Mexico sits
The same service costs 6.3 times more in Washington 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
$1,514
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.