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 $107.15 Median $1,000.00 Typical High $7,762.47 | Facility | None | $107.15 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $181.97 | Professional | None | $107.15 | $158.49 | $181.97 |
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 $58.88 Median $117.49 Typical High $165.96 | Professional | None | $58.88 | $117.49 | $165.96 |
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 $89.13 Median $138.04 Typical High $208.93 | Professional | None | $89.13 | $138.04 | $208.93 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $33.11 Typical High $162.18 | Professional | None | $19.50 | $33.11 | $162.18 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $218.78 Typical High $602.56 | Facility | None | $151.36 | $218.78 | $602.56 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $199.53 | Professional | None | $91.20 | $144.54 | $199.53 |
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 $95.50 Median $141.25 Typical High $194.98 | Professional | None | $95.50 | $141.25 | $194.98 |
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 $53.70 Median $79.43 Typical High $91.20 | Professional | 52 · Reduced service | $53.70 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $31.62 Typical High $36.31 | Professional | 53 · Discontinued | $21.38 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $79.43 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $15.85 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.85 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.72 | $15.85 | $18.20 |
Where New Mexico sits
The same service costs 4.5 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· 27th of 51
$141
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.