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 $57.54 Median $1,047.13 Typical High $7,762.47 | Facility | None | $57.54 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $208.93 | Professional | None | $74.13 | $138.04 | $208.93 |
BCBS New Mexico Setting Facility Modifier None Typical Low $147.91 Median $524.81 Typical High $812.83 | Facility | None | $147.91 | $524.81 | $812.83 |
BCBS New Mexico Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $194.98 | Professional | None | $81.28 | $120.23 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $275.42 | Professional | None | $75.86 | $134.90 | $275.42 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $141.25 Typical High $234.42 | Professional | None | $33.11 | $141.25 | $234.42 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $338.84 | Facility | None | $158.49 | $190.55 | $338.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $281.84 | Professional | None | $79.43 | $177.83 | $281.84 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $870.96 | Facility | None | $398.11 | $398.11 | $870.96 |
United Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $295.12 | Professional | None | $75.86 | $141.25 | $295.12 |
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 $28.84 Median $41.69 Typical High $97.72 | Professional | 52 · Reduced service | $28.84 | $41.69 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $16.60 Typical High $38.90 | Professional | 53 · Discontinued | $11.48 | $16.60 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $63.10 Typical High $144.54 | Professional | 54 · Surgery only | $43.65 | $63.10 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.59 Typical High $28.84 | Professional | 55 · Aftercare only | $8.71 | $12.59 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.32 Typical High $19.50 | Professional | 56 · Pre-op care only | $5.75 | $8.32 | $19.50 |
Where New Mexico sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 30th of 51
$151
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.