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 $17.78 Median $28.18 Typical High $50.12 | Facility | None | $17.78 | $28.18 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $32.36 Typical High $50.12 | Professional | None | $16.60 | $32.36 | $50.12 |
BCBS New Mexico Setting Facility Modifier None Typical Low $26.92 Median $97.72 Typical High $147.91 | Facility | None | $26.92 | $97.72 | $147.91 |
BCBS New Mexico Setting Professional Modifier None Typical Low $17.78 Median $28.84 Typical High $56.23 | Professional | None | $17.78 | $28.84 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Facility | None | $537.03 | $537.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $30.20 Typical High $50.12 | Professional | None | $18.20 | $30.20 | $50.12 |
Molina Setting Professional Modifier None Typical Low $4.57 Median $22.91 Typical High $38.02 | Professional | None | $4.57 | $22.91 | $38.02 |
Providence Setting Facility Modifier None Typical Low $14.45 Median $31.62 Typical High $537.03 | Facility | None | $14.45 | $31.62 | $537.03 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $29.51 Typical High $50.12 | Professional | None | $18.20 | $29.51 | $50.12 |
United Setting Facility Modifier None Typical Low $199.53 Median $263.03 Typical High $1,318.26 | Facility | None | $199.53 | $263.03 | $1,318.26 |
United Setting Professional Modifier None Typical Low $16.22 Median $28.84 Typical High $52.48 | Professional | None | $16.22 | $28.84 | $52.48 |
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 $8.71 Median $14.79 Typical High $24.55 | Professional | 52 · Reduced service | $8.71 | $14.79 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $5.89 Typical High $10.00 | Professional | 53 · Discontinued | $3.55 | $5.89 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.18 Median $21.88 Typical High $37.15 | Professional | 54 · Surgery only | $13.18 | $21.88 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $4.47 Typical High $7.41 | Professional | 55 · Aftercare only | $2.63 | $4.47 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.95 Typical High $5.01 | Professional | 56 · Pre-op care only | $1.78 | $2.95 | $5.01 |
Where New Mexico sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 34th of 51
$32.36
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.