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 $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $23.44 Typical High $23.99 | Professional | None | $16.98 | $23.44 | $23.99 |
BCBS New Mexico Setting Professional Modifier None Typical Low $19.95 Median $26.30 Typical High $26.30 | Professional | None | $19.95 | $26.30 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
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 $35.48 Median $35.48 Typical High $69.18 | Facility | None | $35.48 | $35.48 | $69.18 |
Providence Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $36.31 | Professional | None | $13.80 | $13.80 | $36.31 |
United Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $23.99 | Professional | None | $14.13 | $14.13 | $23.99 |
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 $10.47 Median $11.75 Typical High $12.02 | Professional | 52 · Reduced service | $10.47 | $11.75 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.68 Typical High $4.79 | Professional | 53 · Discontinued | $4.17 | $4.68 | $4.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $17.78 Typical High $18.20 | Professional | 54 · Surgery only | $15.49 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.55 Typical High $3.63 | Professional | 55 · Aftercare only | $3.09 | $3.55 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.34 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.04 | $2.34 | $2.40 |
Where New Mexico sits
The same service costs 2.6 times more in Hawaii 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· 32nd of 51
$19.95
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.