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 $549.54 Median $1,000.00 Typical High $7,762.47 | Facility | None | $549.54 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $776.25 | Professional | None | $512.86 | $776.25 | $776.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $204.17 Median $2,344.23 Typical High $3,090.30 | Professional | None | $204.17 | $2,344.23 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,398.83 Typical High $6,760.83 | Facility | None | $537.03 | $2,398.83 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $954.99 | Professional | None | $575.44 | $660.69 | $954.99 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $245.47 Typical High $338.84 | Professional | None | $50.12 | $245.47 | $338.84 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $794.33 Typical High $5,754.40 | Facility | None | $537.03 | $794.33 | $5,754.40 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $954.99 | Professional | None | $549.54 | $660.69 | $954.99 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $2,454.71 Typical High $9,549.93 | Facility | None | $1,230.27 | $2,454.71 | $9,549.93 |
United Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $602.56 | Professional | None | $288.40 | $446.68 | $602.56 |
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 $257.04 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $257.04 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $102.33 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $389.05 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $77.62 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $51.29 | $77.62 | $77.62 |
Where New Mexico sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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· 27th of 51
$631
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.