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 $117.49 Median $302.00 Typical High $2,137.96 | Facility | None | $117.49 | $302.00 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $194.98 Typical High $295.12 | Professional | None | $77.62 | $194.98 | $295.12 |
BCBS New Mexico Setting Professional Modifier None Typical Low $85.11 Median $190.55 Typical High $251.19 | Professional | None | $85.11 | $190.55 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $316.23 | Professional | None | $85.11 | $128.82 | $316.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $144.54 Typical High $239.88 | Professional | None | $33.11 | $144.54 | $239.88 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $331.13 | Professional | None | $85.11 | $141.25 | $331.13 |
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 $85.11 Median $169.82 Typical High $371.54 | Professional | None | $85.11 | $169.82 | $371.54 |
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 $38.90 Median $87.10 Typical High $147.91 | Professional | 52 · Reduced service | $38.90 | $87.10 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $35.48 Typical High $58.88 | Professional | 53 · Discontinued | $15.49 | $35.48 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $131.83 Typical High $218.78 | Professional | 54 · Surgery only | $57.54 | $131.83 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $26.30 Typical High $43.65 | Professional | 55 · Aftercare only | $11.75 | $26.30 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $17.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $7.76 | $17.38 | $29.51 |
Where New Mexico sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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
$162
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.