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 $25.70 Median $25.70 Typical High $75.86 | Facility | None | $25.70 | $25.70 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $69.18 Typical High $134.90 | Professional | None | $29.51 | $69.18 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
BCBS New Mexico Setting Facility Modifier None Typical Low $56.23 Median $199.53 Typical High $309.03 | Facility | None | $56.23 | $199.53 | $309.03 |
BCBS New Mexico Setting Professional Modifier None Typical Low $20.42 Median $56.23 Typical High $79.43 | Professional | None | $20.42 | $56.23 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $81.28 Typical High $125.89 | Professional | None | $33.88 | $81.28 | $125.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $67.61 Typical High $114.82 | Professional | None | $33.11 | $67.61 | $114.82 |
Providence Setting Facility Modifier None Typical Low $38.02 Median $154.88 Typical High $181.97 | Facility | None | $38.02 | $154.88 | $181.97 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $85.11 Typical High $131.83 | Professional | None | $33.88 | $85.11 | $131.83 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $316.23 | Facility | None | $141.25 | $141.25 | $316.23 |
United Setting Professional Modifier None Typical Low $33.88 Median $72.44 Typical High $141.25 | Professional | None | $33.88 | $72.44 | $141.25 |
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 $12.88 Median $26.30 Typical High $67.61 | Professional | 52 · Reduced service | $12.88 | $26.30 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $10.72 Typical High $26.92 | Professional | 53 · Discontinued | $5.13 | $10.72 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $7.94 Typical High $19.95 | Professional | 55 · Aftercare only | $3.89 | $7.94 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $5.25 Typical High $13.49 | Professional | 56 · Pre-op care only | $2.57 | $5.25 | $13.49 |
Where New Mexico sits
The same service costs 3.6 times more in North Carolina 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· 39th of 51
$70.79
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.