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 $14.79 Median $14.79 Typical High $371.54 | Facility | None | $14.79 | $14.79 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $23.99 Typical High $501.19 | Professional | None | $21.38 | $23.99 | $501.19 |
BCBS New Mexico Setting Facility Modifier None Typical Low $117.49 Median $416.87 Typical High $645.65 | Facility | None | $117.49 | $416.87 | $645.65 |
BCBS New Mexico Setting Professional Modifier None Typical Low $12.88 Median $199.53 Typical High $380.19 | Professional | None | $12.88 | $199.53 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $32.36 Typical High $426.58 | Professional | None | $16.98 | $32.36 | $426.58 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $346.74 Typical High $575.44 | Professional | None | $33.11 | $346.74 | $575.44 |
Providence Setting Professional Modifier None Typical Low $17.78 Median $34.67 Typical High $524.81 | Professional | None | $17.78 | $34.67 | $524.81 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $870.96 | Facility | None | $398.11 | $398.11 | $870.96 |
United Setting Professional Modifier None Typical Low $16.22 Median $75.86 Typical High $331.13 | Professional | None | $16.22 | $75.86 | $331.13 |
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 $7.41 Median $10.72 Typical High $251.19 | Professional | 52 · Reduced service | $7.41 | $10.72 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $4.27 Typical High $100.00 | Professional | 53 · Discontinued | $2.95 | $4.27 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $3.24 Typical High $75.86 | Professional | 55 · Aftercare only | $2.24 | $3.24 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $2.14 Typical High $50.12 | Professional | 56 · Pre-op care only | $1.48 | $2.14 | $50.12 |
Where New Mexico sits
The same service costs 28.2 times more in Hawaii 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· 24th of 51
$145
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.