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 $7,762.47 | Facility | None | $398.11 | $2,089.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $2,041.74 Typical High $3,467.37 | Professional | None | $398.11 | $2,041.74 | $3,467.37 |
BCBS New Mexico Setting Facility Modifier None Typical Low $3,019.95 Median $10,715.19 Typical High $16,595.87 | Facility | None | $3,019.95 | $10,715.19 | $16,595.87 |
BCBS New Mexico Setting Professional Modifier None Typical Low $416.87 Median $1,905.46 Typical High $2,754.23 | Professional | None | $416.87 | $1,905.46 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $3,235.94 | Professional | None | $426.58 | $660.69 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,621.81 Typical High $2,691.53 | Professional | None | $33.11 | $1,621.81 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $426.58 Median $741.31 Typical High $3,981.07 | Professional | None | $426.58 | $741.31 | $3,981.07 |
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 $407.38 Median $1,862.09 Typical High $4,168.69 | Professional | None | $407.38 | $1,862.09 | $4,168.69 |
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 $199.53 Median $1,023.29 Typical High $1,737.80 | Professional | 52 · Reduced service | $199.53 | $1,023.29 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $407.38 Typical High $707.95 | Professional | 53 · Discontinued | $79.43 | $407.38 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $1,513.56 Typical High $2,630.27 | Professional | 54 · Surgery only | $295.12 | $1,513.56 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $309.03 Typical High $524.81 | Professional | 55 · Aftercare only | $58.88 | $309.03 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $204.17 Typical High $346.74 | Professional | 56 · Pre-op care only | $39.81 | $204.17 | $346.74 |
Where New Mexico sits
The same service costs 6.9 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
$1,622
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.