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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | None | $31.62 | $40.74 | $40.74 |
BCBS New Mexico Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | None | $46.77 | $46.77 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $64.57 | Facility | None | $31.62 | $31.62 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $91.20 | Professional | None | $51.29 | $57.54 | $91.20 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $64.57 | Facility | None | $31.62 | $31.62 | $64.57 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
United Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
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 $15.85 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $15.85 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $6.46 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $4.79 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.24 | $4.07 | $4.07 |
Where New Mexico sits
The same service costs 1.7 times more in Hawaii than in Kentucky. 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· 43rd of 51
$31.62
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.