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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $239.88 | Professional | None | $151.36 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $117.49 Typical High $120.23 | Professional | 52 · Reduced service | $74.13 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $46.77 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $34.67 Typical High $36.31 | Professional | 55 · Aftercare only | $22.39 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.44 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $23.44 | $23.99 |
BCBS New Mexico Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $223.87 | Professional | None | $169.82 | $177.83 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $436.52 | Professional | None | $323.59 | $323.59 | $436.52 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $208.93 Typical High $218.78 | Facility | None | $204.17 | $208.93 | $218.78 |
Providence Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $288.40 | Facility | None | $245.47 | $245.47 | $288.40 |
United Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $158.49 | Professional | None | $97.72 | $104.71 | $158.49 |
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 3.3 times more in Alaska 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· 17th of 51
$178
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.