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 $53.70 Median $1,000.00 Typical High $7,762.47 | Facility | None | $53.70 | $1,000.00 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $151.36 Typical High $218.78 | Professional | None | $60.26 | $151.36 | $218.78 |
BCBS New Mexico Setting Facility Modifier None Typical Low $128.82 Median $457.09 Typical High $707.95 | Facility | None | $128.82 | $457.09 | $707.95 |
BCBS New Mexico Setting Professional Modifier None Typical Low $60.26 Median $134.90 Typical High $263.03 | Professional | None | $60.26 | $134.90 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $162.18 Typical High $275.42 | Professional | None | $70.79 | $162.18 | $275.42 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $162.18 Typical High $275.42 | Professional | None | $33.11 | $162.18 | $275.42 |
Providence Setting Facility Modifier None Typical Low $75.86 Median $194.98 Typical High $208.93 | Facility | None | $75.86 | $194.98 | $208.93 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $186.21 Typical High $346.74 | Professional | None | $77.62 | $186.21 | $346.74 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
United Setting Professional Modifier None Typical Low $70.79 Median $154.88 Typical High $338.84 | Professional | None | $70.79 | $154.88 | $338.84 |
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 $26.92 Median $74.13 Typical High $109.65 | Professional | 52 · Reduced service | $26.92 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $30.20 Typical High $43.65 | Professional | 53 · Discontinued | $10.72 | $30.20 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $112.20 Typical High $162.18 | Professional | 54 · Surgery only | $40.74 | $112.20 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $22.39 Typical High $32.36 | Professional | 55 · Aftercare only | $8.13 | $22.39 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $15.14 Typical High $21.88 | Professional | 56 · Pre-op care only | $5.37 | $15.14 | $21.88 |
Where New Mexico sits
The same service costs 2.9 times more in Washington than in Kentucky. 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· 38th of 51
$162
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.