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 $154.88 Median $1,047.13 Typical High $7,762.47 | Facility | None | $154.88 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $316.23 Typical High $478.63 | Professional | None | $154.88 | $316.23 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
BCBS New Mexico Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $630.96 | Professional | None | $186.21 | $309.03 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $501.19 | Professional | None | $173.78 | $288.40 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $288.40 Typical High $478.63 | Professional | None | $33.11 | $288.40 | $478.63 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $501.19 Typical High $524.81 | Facility | None | $169.82 | $501.19 | $524.81 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $616.60 | Professional | None | $186.21 | $316.23 | $616.60 |
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 $173.78 Median $338.84 Typical High $616.60 | Professional | None | $173.78 | $338.84 | $616.60 |
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 $77.62 Median $147.91 Typical High $239.88 | Professional | 52 · Reduced service | $77.62 | $147.91 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $58.88 Typical High $95.50 | Professional | 53 · Discontinued | $30.90 | $58.88 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $218.78 Typical High $354.81 | Professional | 54 · Surgery only | $117.49 | $218.78 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $44.67 Typical High $70.79 | Professional | 55 · Aftercare only | $23.44 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $29.51 Typical High $47.86 | Professional | 56 · Pre-op care only | $15.49 | $29.51 | $47.86 |
Where New Mexico sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 40th of 51
$302
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.