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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $25.70 Typical High $58.88 | Professional | None | $23.99 | $25.70 | $58.88 |
Ambetter Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
BCBS New Mexico Setting Professional Modifier None Typical Low $21.88 Median $28.84 Typical High $28.84 | Professional | None | $21.88 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $95.50 | Facility | None | $48.98 | $48.98 | $95.50 |
Providence Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $39.81 | Professional | None | $15.14 | $15.14 | $39.81 |
United Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $26.30 | Professional | None | $15.49 | $15.49 | $26.30 |
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 $12.02 Median $12.88 Typical High $13.18 | Professional | 52 · Reduced service | $12.02 | $12.88 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.13 Typical High $5.25 | Professional | 53 · Discontinued | $4.79 | $5.13 | $5.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $19.50 Typical High $19.95 | Professional | 54 · Surgery only | $17.78 | $19.50 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.89 Typical High $3.98 | Professional | 55 · Aftercare only | $3.63 | $3.89 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.57 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.40 | $2.57 | $2.63 |
Where New Mexico sits
The same service costs 3.1 times more in Rhode Island than in New York. 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
$21.88
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.