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 $77.62 Median $1,047.13 Typical High $7,762.47 | Facility | None | $77.62 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $162.18 | Professional | None | $77.62 | $112.20 | $162.18 |
BCBS New Mexico Setting Professional Modifier None Typical Low $63.10 Median $104.71 Typical High $218.78 | Professional | None | $63.10 | $104.71 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $707.95 | Facility | None | $537.03 | $602.56 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $177.83 | Professional | None | $91.20 | $123.03 | $177.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $102.33 Typical High $173.78 | Professional | None | $33.11 | $102.33 | $173.78 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $602.56 Typical High $707.95 | Facility | None | $537.03 | $602.56 | $707.95 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $186.21 | Professional | None | $91.20 | $123.03 | $186.21 |
United Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $1,318.26 | Facility | None | $199.53 | $245.47 | $1,318.26 |
United Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $199.53 | Professional | None | $91.20 | $134.90 | $199.53 |
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 $38.90 Median $56.23 Typical High $81.28 | Professional | 52 · Reduced service | $38.90 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $22.91 Typical High $32.36 | Professional | 53 · Discontinued | $15.85 | $22.91 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $85.11 Typical High $123.03 | Professional | 54 · Surgery only | $58.88 | $85.11 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $16.98 Typical High $24.55 | Professional | 55 · Aftercare only | $11.75 | $16.98 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $11.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.76 | $11.22 | $16.22 |
Where New Mexico sits
The same service costs 3.5 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· 28th of 51
$126
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.