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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $107.15 | Professional | None | $67.61 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $50.12 Typical High $53.70 | Professional | 52 · Reduced service | $33.88 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $19.95 Typical High $21.38 | Professional | 53 · Discontinued | $13.80 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.14 Typical High $15.85 | Professional | 55 · Aftercare only | $10.23 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.00 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.76 | $10.00 | $10.72 |
BCBS New Mexico Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $97.72 | Professional | None | $72.44 | $81.28 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $162.18 | Professional | None | $120.23 | $120.23 | $162.18 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $89.13 Typical High $93.33 | Facility | None | $87.10 | $89.13 | $93.33 |
Providence Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $131.83 | Facility | None | $112.20 | $112.20 | $131.83 |
United Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $74.13 | Professional | None | $44.67 | $48.98 | $74.13 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where New Mexico sits
The same service costs 2.6 times more in Hawaii than in Indiana. 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· 24th of 51
$81.28
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.