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 $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $16.60 Typical High $16.60 | Professional | None | $14.13 | $16.60 | $16.60 |
BCBS New Mexico Setting Professional Modifier None Typical Low $14.13 Median $18.62 Typical High $18.62 | Professional | None | $14.13 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
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 $29.51 Median $29.51 Typical High $56.23 | Facility | None | $29.51 | $29.51 | $56.23 |
Providence Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $25.70 | Professional | None | $9.77 | $9.77 | $25.70 |
United Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $16.98 | Professional | None | $9.77 | $9.77 | $16.98 |
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 $7.59 Median $8.32 Typical High $8.51 | Professional | 52 · Reduced service | $7.59 | $8.32 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.31 Typical High $3.39 | Professional | 53 · Discontinued | $3.09 | $3.31 | $3.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.48 Median $12.30 Typical High $12.59 | Professional | 54 · Surgery only | $11.48 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.45 Typical High $2.51 | Professional | 55 · Aftercare only | $2.29 | $2.45 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.66 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.51 | $1.66 | $1.70 |
Where New Mexico sits
The same service costs 2.9 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· 33rd of 51
$14.13
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.