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 $54.95 Median $288.40 Typical High $2,137.96 | Facility | None | $54.95 | $288.40 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $141.25 Typical High $263.03 | Professional | None | $38.90 | $141.25 | $263.03 |
BCBS New Mexico Setting Professional Modifier None Typical Low $44.67 Median $107.15 Typical High $251.19 | Professional | None | $44.67 | $107.15 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $245.47 | Professional | None | $44.67 | $69.18 | $245.47 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $144.54 Typical High $245.47 | Professional | None | $28.84 | $144.54 | $245.47 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $234.42 Typical High $234.42 | Facility | None | $43.65 | $234.42 | $234.42 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $81.28 Typical High $275.42 | Professional | None | $45.71 | $81.28 | $275.42 |
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 $39.81 Median $107.15 Typical High $288.40 | Professional | None | $39.81 | $107.15 | $288.40 |
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 $19.95 Median $74.13 Typical High $131.83 | Professional | 52 · Reduced service | $19.95 | $74.13 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $30.20 Typical High $52.48 | Professional | 53 · Discontinued | $7.94 | $30.20 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $112.20 Typical High $194.98 | Professional | 54 · Surgery only | $29.51 | $112.20 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $22.39 Typical High $38.90 | Professional | 55 · Aftercare only | $5.89 | $22.39 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $14.79 Typical High $26.30 | Professional | 56 · Pre-op care only | $3.98 | $14.79 | $26.30 |
Where New Mexico sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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· 41st of 51
$117
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.