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 $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $912.01 | Professional | None | $630.96 | $912.01 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
BCBS New Mexico Setting Professional Modifier None Typical Low $549.54 Median $575.44 Typical High $1,023.29 | Professional | None | $549.54 | $575.44 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,122.02 | Professional | None | $724.44 | $891.25 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,096.48 Typical High $1,096.48 | Professional | None | $33.11 | $1,096.48 | $1,096.48 |
Providence Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,174.90 | Professional | None | $724.44 | $891.25 | $1,174.90 |
United Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,258.93 | Professional | None | $724.44 | $912.01 | $1,258.93 |
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 $316.23 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $316.23 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $125.89 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $93.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $63.10 | $91.20 | $91.20 |
Where New Mexico sits
The same service costs 3.2 times more in Alaska than in New York. 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
$912
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.