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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $346.74 | Professional | None | $239.88 | $346.74 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | None | $257.04 | $302.00 | $302.00 |
BCBS New Mexico Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $371.54 | Professional | None | $208.93 | $213.80 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $426.58 | Professional | None | $263.03 | $323.59 | $426.58 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $416.87 Typical High $416.87 | Professional | None | $33.11 | $416.87 | $416.87 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $436.52 | Professional | None | $263.03 | $331.13 | $436.52 |
United Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $467.74 | Professional | None | $263.03 | $338.84 | $467.74 |
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 $120.23 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $120.23 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $47.86 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $35.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $23.99 | $34.67 | $34.67 |
Where New Mexico sits
The same service costs 2.8 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· 33rd of 51
$295
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.