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 $95.50 Median $169.82 Typical High $181.97 | Facility | None | $95.50 | $169.82 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $169.82 | Professional | None | $95.50 | $169.82 | $169.82 |
BCBS New Mexico Setting Facility Modifier None Typical Low $114.82 Median $407.38 Typical High $630.96 | Facility | None | $114.82 | $407.38 | $630.96 |
BCBS New Mexico Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $165.96 | Professional | None | $104.71 | $125.89 | $165.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $138.04 Typical High $138.04 | Professional | None | $33.11 | $138.04 | $138.04 |
Providence Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $151.36 | Facility | None | $138.04 | $138.04 | $151.36 |
Providence Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $173.78 | Professional | None | $104.71 | $125.89 | $173.78 |
United Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $1,445.44 | Facility | None | $645.65 | $645.65 | $1,445.44 |
United Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $190.55 | Professional | None | $104.71 | $147.91 | $190.55 |
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 $47.86 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $47.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $19.50 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $14.45 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $9.55 | $16.98 | $16.98 |
Where New Mexico sits
The same service costs 3.0 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· 22nd of 51
$138
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.