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 $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $20.42 Typical High $23.44 | Professional | None | $14.79 | $20.42 | $23.44 |
BCBS New Mexico Setting Facility Modifier None Typical Low $239.88 Median $851.14 Typical High $1,348.96 | Facility | None | $239.88 | $851.14 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $36.31 Typical High $51.29 | Professional | None | $25.70 | $36.31 | $51.29 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $33.11 | Professional | None | $28.84 | $28.84 | $33.11 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $36.31 Typical High $51.29 | Professional | None | $25.70 | $36.31 | $51.29 |
United Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $954.99 | Facility | None | $426.58 | $426.58 | $954.99 |
United Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $58.88 | Professional | None | $28.84 | $44.67 | $58.88 |
4 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 $7.41 Median $10.23 Typical High $11.75 | Professional | 52 · Reduced service | $7.41 | $10.23 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $4.07 Typical High $4.68 | Professional | 53 · Discontinued | $2.95 | $4.07 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $3.09 Typical High $3.47 | Professional | 55 · Aftercare only | $2.19 | $3.09 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $2.04 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.48 | $2.04 | $2.29 |
Where New Mexico sits
The same service costs 2.5 times more in Iowa than in Pennsylvania. 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· 17th of 51
$36.31
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.