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 $173.78 Median $1,380.38 Typical High $7,762.47 | Facility | None | $173.78 | $1,380.38 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $245.47 | Professional | None | $162.18 | $245.47 | $245.47 |
BCBS New Mexico Setting Facility Modifier None Typical Low $478.63 Median $3,019.95 Typical High $9,772.37 | Facility | None | $478.63 | $3,019.95 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,288.25 Typical High $1,513.56 | Facility | None | $537.03 | $1,288.25 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $323.59 | Professional | None | $181.97 | $229.09 | $323.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $52.48 Typical High $263.03 | Professional | None | $33.11 | $52.48 | $263.03 |
Providence Setting Facility Modifier None Typical Low $199.53 Median $537.03 Typical High $1,513.56 | Facility | None | $199.53 | $537.03 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $346.74 | Professional | None | $181.97 | $229.09 | $346.74 |
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 $165.96 Median $251.19 Typical High $338.84 | Professional | None | $165.96 | $251.19 | $338.84 |
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 $81.28 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $81.28 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $32.36 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $120.23 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $23.99 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.22 | $24.55 | $24.55 |
Where New Mexico sits
The same service costs 4.5 times more in Alaska than in New York. 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· 20th of 51
$257
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.