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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $50.12 | Professional | None | $42.66 | $44.67 | $50.12 |
BCBS New Mexico Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $134.90 | Professional | None | $85.11 | $85.11 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $269.15 | Facility | None | $125.89 | $177.83 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $60.26 | Professional | None | $50.12 | $60.26 | $60.26 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $257.04 | Facility | None | $125.89 | $177.83 | $257.04 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $21.38 Median $21.88 Typical High $25.12 | Professional | 52 · Reduced service | $21.38 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.91 Typical High $10.00 | Professional | 53 · Discontinued | $8.71 | $8.91 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $33.11 Typical High $38.02 | Professional | 54 · Surgery only | $32.36 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $7.59 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.47 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.27 | $4.47 | $5.01 |
Where New Mexico sits
The same service costs 6.3 times more in North Dakota than in Hawaii. 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· 16th of 51
$126
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.