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 $39.81 Median $39.81 Typical High $120.23 | Facility | None | $39.81 | $39.81 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $83.18 Typical High $213.80 | Professional | None | $40.74 | $83.18 | $213.80 |
BCBS New Mexico Setting Facility Modifier None Typical Low $190.55 Median $676.08 Typical High $1,047.13 | Facility | None | $190.55 | $676.08 | $1,047.13 |
BCBS New Mexico Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $117.49 | Professional | None | $41.69 | $41.69 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $123.03 Typical High $181.97 | Professional | None | $50.12 | $123.03 | $181.97 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $107.15 Typical High $177.83 | Professional | None | $33.11 | $107.15 | $177.83 |
Providence Setting Facility Modifier None Typical Low $51.29 Median $186.21 Typical High $208.93 | Facility | None | $51.29 | $186.21 | $208.93 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $128.82 Typical High $181.97 | Professional | None | $50.12 | $128.82 | $181.97 |
United Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $933.25 | Facility | None | $416.87 | $416.87 | $933.25 |
United Setting Professional Modifier None Typical Low $52.48 Median $109.65 Typical High $204.17 | Professional | None | $52.48 | $109.65 | $204.17 |
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 $19.95 Median $41.69 Typical High $104.71 | Professional | 52 · Reduced service | $19.95 | $41.69 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $16.60 Typical High $42.66 | Professional | 53 · Discontinued | $7.94 | $16.60 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $12.59 Typical High $31.62 | Professional | 55 · Aftercare only | $6.03 | $12.59 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $8.32 Typical High $21.38 | Professional | 56 · Pre-op care only | $3.98 | $8.32 | $21.38 |
Where New Mexico sits
The same service costs 3.5 times more in Wisconsin than in Washington, DC. 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· 29th of 51
$115
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.