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 $263.03 Median $1,445.44 Typical High $7,762.47 | Facility | None | $263.03 | $1,445.44 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $1,202.26 Typical High $2,137.96 | Professional | None | $239.88 | $1,202.26 | $2,137.96 |
BCBS New Mexico Setting Professional Modifier None Typical Low $309.03 Median $870.96 Typical High $1,778.28 | Professional | None | $309.03 | $870.96 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $1,778.28 | Professional | None | $257.04 | $416.87 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,047.13 Typical High $1,737.80 | Professional | None | $33.11 | $1,047.13 | $1,737.80 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $524.81 Typical High $2,344.23 | Professional | None | $257.04 | $524.81 | $2,344.23 |
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 $251.19 Median $1,148.15 Typical High $2,290.87 | Professional | None | $251.19 | $1,148.15 | $2,290.87 |
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 $131.83 Median $645.65 Typical High $1,071.52 | Professional | 52 · Reduced service | $131.83 | $645.65 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $257.04 Typical High $436.52 | Professional | 53 · Discontinued | $52.48 | $257.04 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $977.24 Typical High $1,621.81 | Professional | 54 · Surgery only | $199.53 | $977.24 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $194.98 Typical High $323.59 | Professional | 55 · Aftercare only | $39.81 | $194.98 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $128.82 Typical High $213.80 | Professional | 56 · Pre-op care only | $26.30 | $128.82 | $213.80 |
Where New Mexico sits
The same service costs 6.5 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· 44th 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.