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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | None | $28.84 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $64.57 | Facility | None | $32.36 | $32.36 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Providence Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $64.57 | Facility | None | $32.36 | $32.36 | $64.57 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
United Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
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 $14.13 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $14.13 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $5.75 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $4.27 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.82 | $3.63 | $3.63 |
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· 12th of 51
$32.36
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.