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 $50.12 Median $1,000.00 Typical High $7,762.47 | Facility | None | $50.12 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $97.72 | Professional | None | $50.12 | $75.86 | $97.72 |
BCBS New Mexico Setting Professional Modifier None Typical Low $33.88 Median $56.23 Typical High $112.20 | Professional | None | $33.88 | $56.23 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $45.71 Typical High $602.56 | Facility | None | $38.02 | $45.71 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $109.65 | Professional | None | $45.71 | $75.86 | $109.65 |
Molina Setting Professional Modifier None Typical Low $10.47 Median $33.11 Typical High $87.10 | Professional | None | $10.47 | $33.11 | $87.10 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $66.07 Typical High $537.03 | Facility | None | $39.81 | $66.07 | $537.03 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $109.65 | Professional | None | $48.98 | $79.43 | $109.65 |
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 $53.70 Median $75.86 Typical High $107.15 | Professional | None | $53.70 | $75.86 | $107.15 |
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 $25.12 Median $38.02 Typical High $48.98 | Professional | 52 · Reduced service | $25.12 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $15.14 Typical High $19.50 | Professional | 53 · Discontinued | $10.00 | $15.14 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $56.23 Typical High $72.44 | Professional | 54 · Surgery only | $38.02 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $7.59 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.59 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.01 | $7.59 | $9.77 |
Where New Mexico sits
The same service costs 3.7 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· 25th of 51
$75.86
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.