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 $18.20 Median $18.20 Typical High $28.84 | Facility | None | $18.20 | $18.20 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $25.70 Typical High $35.48 | Professional | None | $22.39 | $25.70 | $35.48 |
Ambetter Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
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 $14.45 Median $23.99 Typical High $35.48 | Professional | None | $14.45 | $23.99 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $19.95 Typical High $602.56 | Facility | None | $16.60 | $19.95 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $36.31 Typical High $51.29 | Professional | None | $24.55 | $36.31 | $51.29 |
Molina Setting Professional Modifier None Typical Low $4.79 Median $23.99 Typical High $39.81 | Professional | None | $4.79 | $23.99 | $39.81 |
Providence Setting Facility Modifier None Typical Low $17.38 Median $28.84 Typical High $537.03 | Facility | None | $17.38 | $28.84 | $537.03 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $36.31 Typical High $51.29 | Professional | None | $24.55 | $36.31 | $51.29 |
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 $22.91 Median $39.81 Typical High $57.54 | Professional | None | $22.91 | $39.81 | $57.54 |
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 $9.12 Median $11.75 Typical High $17.78 | Professional | 52 · Reduced service | $9.12 | $11.75 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.68 Typical High $7.08 | Professional | 53 · Discontinued | $3.63 | $4.68 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $3.55 Typical High $5.37 | Professional | 55 · Aftercare only | $2.69 | $3.55 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.34 Typical High $3.55 | Professional | 56 · Pre-op care only | $1.82 | $2.34 | $3.55 |
Where New Mexico sits
The same service costs 3.0 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· 24th of 51
$33.11
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.