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 $67.61 Median $1,047.13 Typical High $7,762.47 | Facility | None | $67.61 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $239.88 | Professional | None | $66.07 | $112.20 | $239.88 |
BCBS New Mexico Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $239.88 | Professional | None | $70.79 | $117.49 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $234.42 Typical High $602.56 | Facility | None | $169.82 | $234.42 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $229.09 | Professional | None | $72.44 | $138.04 | $229.09 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $138.04 Typical High $234.42 | Professional | None | $27.54 | $138.04 | $234.42 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $234.42 Typical High $602.56 | Facility | None | $169.82 | $234.42 | $602.56 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $234.42 | Professional | None | $72.44 | $138.04 | $234.42 |
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 $77.62 Median $134.90 Typical High $229.09 | Professional | None | $77.62 | $134.90 | $229.09 |
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 $33.11 Median $47.86 Typical High $120.23 | Professional | 52 · Reduced service | $33.11 | $47.86 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $19.05 Typical High $47.86 | Professional | 53 · Discontinued | $13.18 | $19.05 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $72.44 Typical High $177.83 | Professional | 54 · Surgery only | $48.98 | $72.44 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $14.45 Typical High $36.31 | Professional | 55 · Aftercare only | $9.77 | $14.45 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.55 Typical High $23.99 | Professional | 56 · Pre-op care only | $6.61 | $9.55 | $23.99 |
Where New Mexico sits
The same service costs 3.7 times more in Alaska than in Washington, DC. 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
$138
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.