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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $812.83 | Professional | None | $100.00 | $147.91 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
BCBS New Mexico Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $177.83 | Professional | None | $114.82 | $147.91 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $204.17 | Professional | None | $128.82 | $158.49 | $204.17 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $173.78 Typical High $173.78 | Professional | None | $33.11 | $173.78 | $173.78 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $151.36 Typical High $158.49 | Facility | None | $128.82 | $151.36 | $158.49 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $208.93 | Professional | None | $128.82 | $162.18 | $208.93 |
United Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $229.09 | Professional | None | $128.82 | $173.78 | $229.09 |
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 $50.12 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $50.12 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $19.95 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $14.79 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.00 | $14.79 | $14.79 |
Where New Mexico sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 21st of 51
$148
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.