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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $30.20 Typical High $30.90 | Professional | None | $23.99 | $30.20 | $30.90 |
BCBS New Mexico Setting Professional Modifier None Typical Low $25.70 Median $33.88 Typical High $33.88 | Professional | None | $25.70 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
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 $44.67 Median $44.67 Typical High $87.10 | Facility | None | $44.67 | $44.67 | $87.10 |
Providence Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $46.77 | Professional | None | $17.78 | $17.78 | $46.77 |
United Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $30.90 | Professional | None | $18.20 | $18.20 | $30.90 |
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 $12.88 Median $15.14 Typical High $15.49 | Professional | 52 · Reduced service | $12.88 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $6.03 Typical High $6.17 | Professional | 53 · Discontinued | $5.13 | $6.03 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $22.91 Typical High $23.44 | Professional | 54 · Surgery only | $19.50 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.57 Typical High $4.68 | Professional | 55 · Aftercare only | $3.89 | $4.57 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.02 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.57 | $3.02 | $3.09 |
Where New Mexico sits
The same service costs 2.8 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· 30th of 51
$25.70
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.