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 $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $6.03 Typical High $6.17 | Professional | None | $5.50 | $6.03 | $6.17 |
BCBS New Mexico Setting Professional Modifier None Typical Low $5.01 Median $6.76 Typical High $6.76 | Professional | None | $5.01 | $6.76 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
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 $14.45 Median $14.45 Typical High $28.18 | Facility | None | $14.45 | $14.45 | $28.18 |
Providence Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $9.12 | Professional | None | $3.47 | $3.47 | $9.12 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $6.03 | Professional | None | $3.55 | $3.55 | $6.03 |
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 $2.75 Median $3.02 Typical High $3.09 | Professional | 52 · Reduced service | $2.75 | $3.02 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.20 Typical High $1.23 | Professional | 53 · Discontinued | $1.12 | $1.20 | $1.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.17 Median $4.47 Typical High $4.57 | Professional | 54 · Surgery only | $4.17 | $4.47 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.89 Typical High $0.91 | Professional | 55 · Aftercare only | $0.83 | $0.89 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.60 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.55 | $0.60 | $0.62 |
Where New Mexico sits
The same service costs 4.1 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
$5.01
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.