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 $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $57.54 | Professional | None | $48.98 | $51.29 | $57.54 |
BCBS New Mexico Setting Facility Modifier None Typical Low $28.84 Median $97.72 Typical High $158.49 | Facility | None | $28.84 | $97.72 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $104.71 | Facility | None | $52.48 | $52.48 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Molina Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $13.49 | Professional | None | $8.91 | $8.91 | $13.49 |
Providence Setting Facility Modifier None Typical Low $8.51 Median $8.91 Typical High $104.71 | Facility | None | $8.51 | $8.91 | $104.71 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $24.55 Median $25.12 Typical High $28.84 | Professional | 52 · Reduced service | $24.55 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.23 Typical High $11.48 | Professional | 53 · Discontinued | $10.00 | $10.23 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.59 Typical High $8.71 | Professional | 55 · Aftercare only | $7.41 | $7.59 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.13 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.90 | $5.13 | $5.75 |
Where New Mexico sits
The same service costs 6.6 times more in Alaska than in Hawaii. 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· 25th of 51
$52.48
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.