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 $58.88 Median $58.88 Typical High $97.72 | Facility | None | $58.88 | $58.88 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $162.18 | Professional | None | $72.44 | $102.33 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $51.29 Typical High $81.28 | Professional | 52 · Reduced service | $35.48 | $51.29 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $15.14 Typical High $24.55 | Professional | 55 · Aftercare only | $10.72 | $15.14 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.23 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.08 | $10.23 | $16.22 |
BCBS New Mexico Setting Facility Modifier None Typical Low $104.71 Median $371.54 Typical High $575.44 | Facility | None | $104.71 | $371.54 | $575.44 |
BCBS New Mexico Setting Professional Modifier None Typical Low $53.70 Median $87.10 Typical High $114.82 | Professional | None | $53.70 | $87.10 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $134.90 | Professional | None | $57.54 | $95.50 | $134.90 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $104.71 Typical High $724.44 | Professional | None | $48.98 | $104.71 | $724.44 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $120.23 Typical High $144.54 | Facility | None | $61.66 | $120.23 | $144.54 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $134.90 | Professional | None | $63.10 | $95.50 | $134.90 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $575.44 | Facility | None | $263.03 | $263.03 | $575.44 |
United Setting Professional Modifier None Typical Low $64.57 Median $102.33 Typical High $173.78 | Professional | None | $64.57 | $102.33 | $173.78 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | 24 · Unrelated visit after surgery | $104.71 | $104.71 | $123.03 |
Where New Mexico sits
The same service costs 4.3 times more in Alaska than in North Carolina. 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· 24th of 51
$95.50
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.