How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | None | $93.33 | $93.33 | $97.72 |
BCBS New Mexico Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $97.72 | Professional | None | $67.61 | $69.18 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $60.26 | Professional | None | $33.11 | $33.11 | $60.26 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Providence Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $239.88 | Professional | None | $83.18 | $83.18 | $239.88 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $151.36 | Professional | None | $91.20 | $125.89 | $151.36 |
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 $46.77 Median $46.77 Typical High $48.98 | Professional | 52 · Reduced service | $46.77 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | 53 · Discontinued | $18.62 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $9.77 |
Where New Mexico sits
The same service costs 3.3 times more in Alaska 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· 37th of 51
$91.20
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.