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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $588.84 | Professional | None | $457.09 | $588.84 | $588.84 |
BCBS New Mexico Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $549.54 | Professional | None | $239.88 | $407.38 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $257.04 | Facility | None | $125.89 | $125.89 | $257.04 |
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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $257.04 | Facility | None | $125.89 | $125.89 | $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 |
4 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 $229.09 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $229.09 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $93.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $58.88 |
Where New Mexico sits
The same service costs 12.0 times more in Wyoming than in North Carolina. 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· 45th 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.