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 $72.44 Median $1,047.13 Typical High $7,762.47 | Facility | None | $72.44 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $147.91 | Professional | None | $72.44 | $107.15 | $147.91 |
BCBS New Mexico Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $194.98 | Professional | None | $54.95 | $91.20 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $165.96 | Professional | None | $75.86 | $109.65 | $165.96 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $100.00 Typical High $165.96 | Professional | None | $19.95 | $100.00 | $165.96 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $630.96 | Facility | None | $158.49 | $158.49 | $630.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $213.80 | Professional | None | $79.43 | $123.03 | $213.80 |
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 $72.44 Median $120.23 Typical High $194.98 | Professional | None | $72.44 | $120.23 | $194.98 |
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 $36.31 Median $53.70 Typical High $74.13 | Professional | 52 · Reduced service | $36.31 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $21.38 Typical High $29.51 | Professional | 53 · Discontinued | $14.79 | $21.38 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $81.28 Typical High $109.65 | Professional | 54 · Surgery only | $54.95 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $16.22 Typical High $21.88 | Professional | 55 · Aftercare only | $10.96 | $16.22 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.72 Typical High $14.79 | Professional | 56 · Pre-op care only | $7.24 | $10.72 | $14.79 |
Where New Mexico sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 35th of 51
$112
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.