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 $72.44 Median $112.20 Typical High $2,137.96 | Facility | None | $72.44 | $112.20 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $107.15 | Professional | None | $67.61 | $72.44 | $107.15 |
BCBS New Mexico Setting Facility Modifier None Typical Low $380.19 Median $1,348.96 Typical High $2,089.30 | Facility | None | $380.19 | $1,348.96 | $2,089.30 |
BCBS New Mexico Setting Professional Modifier None Typical Low $56.23 Median $91.20 Typical High $123.03 | Professional | None | $56.23 | $91.20 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $66.07 Typical High $1,202.26 | Facility | None | $47.86 | $66.07 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $169.82 | Professional | None | $75.86 | $114.82 | $169.82 |
Molina Setting Professional Modifier None Typical Low $12.88 Median $64.57 Typical High $162.18 | Professional | None | $12.88 | $64.57 | $162.18 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $114.82 Typical High $1,288.25 | Facility | None | $50.12 | $114.82 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $173.78 | Professional | None | $75.86 | $117.49 | $173.78 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,348.96 | Facility | None | $199.53 | $275.42 | $1,348.96 |
United Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $158.49 | Professional | None | $63.10 | $97.72 | $158.49 |
6 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 $25.12 Median $36.31 Typical High $51.29 | Professional | 52 · Reduced service | $25.12 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $14.45 Typical High $20.42 | Professional | 53 · Discontinued | $10.00 | $14.45 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $54.95 Typical High $75.86 | Professional | 54 · Surgery only | $38.02 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.96 Typical High $15.14 | Professional | 55 · Aftercare only | $7.59 | $10.96 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.24 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.01 | $7.24 | $10.23 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $102.33 Typical High $109.65 | Professional | 50 · Both sides | $102.33 | $102.33 | $109.65 |
Where New Mexico sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$93.33
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.