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 $74.13 Median $1,047.13 Typical High $7,762.47 | Facility | None | $74.13 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $371.54 Typical High $602.56 | Professional | None | $74.13 | $371.54 | $602.56 |
BCBS New Mexico Setting Facility Modifier None Typical Low $524.81 Median $1,905.46 Typical High $2,884.03 | Facility | None | $524.81 | $1,905.46 | $2,884.03 |
BCBS New Mexico Setting Professional Modifier None Typical Low $83.18 Median $331.13 Typical High $588.84 | Professional | None | $83.18 | $331.13 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $162.18 Typical High $575.44 | Professional | None | $87.10 | $162.18 | $575.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $338.84 Typical High $562.34 | Professional | None | $33.11 | $338.84 | $562.34 |
Providence Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $645.65 | Professional | None | $93.33 | $177.83 | $645.65 |
United Setting Facility Modifier None Typical Low $794.33 Median $7,762.47 Typical High $15,848.93 | Facility | None | $794.33 | $7,762.47 | $15,848.93 |
United Setting Professional Modifier None Typical Low $91.20 Median $371.54 Typical High $676.08 | Professional | None | $91.20 | $371.54 | $676.08 |
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 $37.15 Median $186.21 Typical High $302.00 | Professional | 52 · Reduced service | $37.15 | $186.21 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $74.13 Typical High $120.23 | Professional | 53 · Discontinued | $14.79 | $74.13 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $281.84 Typical High $457.09 | Professional | 54 · Surgery only | $56.23 | $281.84 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $56.23 Typical High $91.20 | Professional | 55 · Aftercare only | $11.22 | $56.23 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $37.15 Typical High $60.26 | Professional | 56 · Pre-op care only | $7.41 | $37.15 | $60.26 |
Where New Mexico sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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
$339
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.