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 $54.95 Median $162.18 Typical High $2,137.96 | Facility | None | $54.95 | $162.18 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $89.13 Typical High $123.03 | Professional | None | $45.71 | $89.13 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
BCBS New Mexico Setting Facility Modifier None Typical Low $302.00 Median $1,096.48 Typical High $1,698.24 | Facility | None | $302.00 | $1,096.48 | $1,698.24 |
BCBS New Mexico Setting Professional Modifier None Typical Low $52.48 Median $100.00 Typical High $112.20 | Professional | None | $52.48 | $100.00 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $123.03 Typical High $169.82 | Professional | None | $64.57 | $123.03 | $169.82 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $74.13 Typical High $123.03 | Professional | None | $14.79 | $74.13 | $123.03 |
Providence Setting Facility Modifier None Typical Low $109.65 Median $181.97 Typical High $1,445.44 | Facility | None | $109.65 | $181.97 | $1,445.44 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $169.82 | Professional | None | $64.57 | $125.89 | $169.82 |
United Setting Facility Modifier None Typical Low $229.09 Median $1,318.26 Typical High $3,019.95 | Facility | None | $229.09 | $1,318.26 | $3,019.95 |
United Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $173.78 | Professional | None | $58.88 | $117.49 | $173.78 |
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 $22.91 Median $41.69 Typical High $53.70 | Professional | 52 · Reduced service | $22.91 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $16.60 Typical High $21.38 | Professional | 53 · Discontinued | $9.12 | $16.60 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $63.10 Typical High $81.28 | Professional | 54 · Surgery only | $34.67 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $12.59 Typical High $16.22 | Professional | 55 · Aftercare only | $6.92 | $12.59 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $8.32 Typical High $10.72 | Professional | 56 · Pre-op care only | $4.57 | $8.32 | $10.72 |
Where New Mexico sits
The same service costs 2.5 times more in North Carolina 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· 24th of 51
$100
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.