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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $34.67 | Professional | None | $30.20 | $30.90 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $63.10 | Facility | None | $31.62 | $31.62 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $48.98 | Professional | None | $33.11 | $33.11 | $48.98 |
Providence Setting Facility Modifier None Typical Low $13.18 Median $16.98 Typical High $63.10 | Facility | None | $13.18 | $16.98 | $63.10 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $14.79 Median $15.14 Typical High $17.38 | Professional | 52 · Reduced service | $14.79 | $15.14 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.17 Typical High $7.08 | Professional | 53 · Discontinued | $6.03 | $6.17 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $5.25 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.09 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.02 | $3.09 | $3.47 |
Where New Mexico sits
Rates are fairly even across states for this service. 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· 34th of 51
$31.62
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.