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 $33.88 Median $33.88 Typical High $77.62 | Facility | None | $33.88 | $33.88 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $128.82 | Professional | None | $40.74 | $69.18 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $34.67 Typical High $64.57 | Professional | 52 · Reduced service | $20.42 | $34.67 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $13.80 Typical High $25.70 | Professional | 53 · Discontinued | $8.13 | $13.80 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.47 Typical High $19.50 | Professional | 55 · Aftercare only | $6.17 | $10.47 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.92 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.07 | $6.92 | $12.88 |
BCBS New Mexico Setting Facility Modifier None Typical Low $151.36 Median $524.81 Typical High $831.76 | Facility | None | $151.36 | $524.81 | $831.76 |
BCBS New Mexico Setting Professional Modifier None Typical Low $30.20 Median $67.61 Typical High $89.13 | Professional | None | $30.20 | $67.61 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $74.13 Typical High $109.65 | Professional | None | $38.02 | $74.13 | $109.65 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $109.65 | Facility | None | $50.12 | $102.33 | $109.65 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $74.13 Typical High $109.65 | Professional | None | $38.02 | $74.13 | $109.65 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $575.44 | Facility | None | $263.03 | $263.03 | $575.44 |
United Setting Professional Modifier None Typical Low $38.90 Median $69.18 Typical High $134.90 | Professional | None | $38.90 | $69.18 | $134.90 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where New Mexico sits
The same service costs 2.5 times more in Alaska than in Washington, DC. 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· 36th of 51
$67.61
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.