How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $41.69 Median $70.79 Typical High $173.78 | Facility | None | $41.69 | $70.79 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $102.33 | Professional | None | $54.95 | $69.18 | $102.33 |
BCBS New Mexico Setting Facility Modifier None Typical Low $107.15 Median $380.19 Typical High $588.84 | Facility | None | $107.15 | $380.19 | $588.84 |
BCBS New Mexico Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $114.82 | Professional | None | $45.71 | $75.86 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $602.56 | Facility | None | $75.86 | $91.20 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $128.82 | Professional | None | $61.66 | $91.20 | $128.82 |
Molina Setting Professional Modifier None Typical Low $14.13 Median $70.79 Typical High $120.23 | Professional | None | $14.13 | $70.79 | $120.23 |
Providence Setting Facility Modifier None Typical Low $75.86 Median $107.15 Typical High $537.03 | Facility | None | $75.86 | $107.15 | $537.03 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $138.04 | Professional | None | $63.10 | $93.33 | $138.04 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $53.70 Median $93.33 Typical High $144.54 | Professional | None | $53.70 | $93.33 | $144.54 |
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 $20.89 Median $38.02 Typical High $51.29 | Professional | 52 · Reduced service | $20.89 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $15.14 Typical High $20.42 | Professional | 53 · Discontinued | $8.32 | $15.14 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $11.48 Typical High $15.49 | Professional | 55 · Aftercare only | $6.31 | $11.48 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.59 Typical High $10.23 | Professional | 56 · Pre-op care only | $4.17 | $7.59 | $10.23 |
Where New Mexico sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 19th of 51
$89.13
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.