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 $61.66 Median $1,047.13 Typical High $7,762.47 | Facility | None | $61.66 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $107.15 | Professional | None | $57.54 | $83.18 | $107.15 |
BCBS New Mexico Setting Facility Modifier None Typical Low $776.25 Median $2,754.23 Typical High $4,265.80 | Facility | None | $776.25 | $2,754.23 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $77.62 Typical High $1,202.26 | Facility | None | $56.23 | $77.62 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $128.82 | Professional | None | $64.57 | $93.33 | $128.82 |
Molina Setting Professional Modifier None Typical Low $12.59 Median $63.10 Typical High $104.71 | Professional | None | $12.59 | $63.10 | $104.71 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $97.72 Typical High $1,288.25 | Facility | None | $58.88 | $97.72 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $128.82 | Professional | None | $67.61 | $93.33 | $128.82 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $4,570.88 | Facility | None | $575.44 | $1,174.90 | $4,570.88 |
United Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $138.04 | Professional | None | $66.07 | $95.50 | $138.04 |
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 $30.20 Median $41.69 Typical High $53.70 | Professional | 52 · Reduced service | $30.20 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $21.38 | Professional | 53 · Discontinued | $12.02 | $16.60 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $61.66 Typical High $79.43 | Professional | 54 · Surgery only | $45.71 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.30 Typical High $15.85 | Professional | 55 · Aftercare only | $9.12 | $12.30 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.32 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.17 | $8.32 | $10.72 |
Where New Mexico sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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· 23rd of 51
$91.20
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.