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 $275.42 Median $1,380.38 Typical High $7,762.47 | Facility | None | $275.42 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $891.25 Typical High $1,513.56 | Professional | None | $275.42 | $891.25 | $1,513.56 |
BCBS New Mexico Setting Professional Modifier None Typical Low $309.03 Median $758.58 Typical High $1,122.02 | Professional | None | $309.03 | $758.58 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $1,659.59 | Professional | None | $302.00 | $457.09 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $676.08 Typical High $1,122.02 | Professional | None | $33.11 | $676.08 | $1,122.02 |
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 $316.23 Median $524.81 Typical High $1,778.28 | Professional | None | $316.23 | $524.81 | $1,778.28 |
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 $269.15 Median $707.95 Typical High $1,949.84 | Professional | None | $269.15 | $707.95 | $1,949.84 |
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 $138.04 Median $436.52 Typical High $741.31 | Professional | 52 · Reduced service | $138.04 | $436.52 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $173.78 Typical High $295.12 | Professional | 53 · Discontinued | $54.95 | $173.78 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $645.65 Typical High $1,096.48 | Professional | 54 · Surgery only | $208.93 | $645.65 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $131.83 Typical High $218.78 | Professional | 55 · Aftercare only | $41.69 | $131.83 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $87.10 Typical High $147.91 | Professional | 56 · Pre-op care only | $27.54 | $87.10 | $147.91 |
Where New Mexico sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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· 38th of 51
$676
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.