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 $20.42 Median $1,000.00 Typical High $7,762.47 | Facility | None | $20.42 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $30.90 Typical High $53.70 | Professional | None | $23.44 | $30.90 | $53.70 |
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 $22.39 Median $26.92 Typical High $45.71 | Professional | None | $22.39 | $26.92 | $45.71 |
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 $23.44 Median $58.88 Typical High $89.13 | Professional | None | $23.44 | $58.88 | $89.13 |
Molina Setting Professional Modifier None Typical Low $5.75 Median $28.84 Typical High $47.86 | Professional | None | $5.75 | $28.84 | $47.86 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $77.62 Typical High $602.56 | Facility | None | $70.79 | $77.62 | $602.56 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $61.66 Typical High $93.33 | Professional | None | $31.62 | $61.66 | $93.33 |
United Setting Facility Modifier None Typical Low $199.53 Median $263.03 Typical High $1,318.26 | Facility | None | $199.53 | $263.03 | $1,318.26 |
United Setting Professional Modifier None Typical Low $35.48 Median $56.23 Typical High $85.11 | Professional | None | $35.48 | $56.23 | $85.11 |
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 $10.23 Median $15.49 Typical High $17.38 | Professional | 52 · Reduced service | $10.23 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $6.17 Typical High $6.92 | Professional | 53 · Discontinued | $4.07 | $6.17 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $22.91 Typical High $26.30 | Professional | 54 · Surgery only | $15.49 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $4.57 Typical High $5.25 | Professional | 55 · Aftercare only | $3.09 | $4.57 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $3.09 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.04 | $3.09 | $3.47 |
Where New Mexico sits
The same service costs 4.3 times more in Wyoming 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· 19th of 51
$46.77
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.