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 $43.65 Median $1,000.00 Typical High $7,762.47 | Facility | None | $43.65 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $95.50 | Professional | None | $43.65 | $66.07 | $95.50 |
BCBS New Mexico Setting Facility Modifier None Typical Low $151.36 Median $524.81 Typical High $831.76 | Facility | None | $151.36 | $524.81 | $831.76 |
BCBS New Mexico Setting Professional Modifier None Typical Low $29.51 Median $50.12 Typical High $91.20 | Professional | None | $29.51 | $50.12 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Facility | None | $537.03 | $537.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $104.71 | Professional | None | $42.66 | $64.57 | $104.71 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $33.11 Typical High $85.11 | Professional | None | $10.23 | $33.11 | $85.11 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $75.86 Typical High $602.56 | Facility | None | $39.81 | $75.86 | $602.56 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $104.71 | Professional | None | $45.71 | $64.57 | $104.71 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $97.72 | Professional | None | $44.67 | $66.07 | $97.72 |
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 $21.38 Median $33.11 Typical High $47.86 | Professional | 52 · Reduced service | $21.38 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $13.18 Typical High $19.05 | Professional | 53 · Discontinued | $8.71 | $13.18 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $50.12 Typical High $72.44 | Professional | 54 · Surgery only | $32.36 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.00 Typical High $14.45 | Professional | 55 · Aftercare only | $6.46 | $10.00 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.61 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.37 | $6.61 | $9.55 |
Where New Mexico sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 33rd of 51
$66.07
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.