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 $44.67 Median $66.07 Typical High $77.62 | Facility | None | $44.67 | $66.07 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $87.10 | Professional | None | $44.67 | $66.07 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $72.44 Typical High $89.13 | Professional | None | $34.67 | $72.44 | $89.13 |
BCBS New Mexico Setting Professional Modifier None Typical Low $40.74 Median $60.26 Typical High $69.18 | Professional | None | $40.74 | $60.26 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $173.78 | Facility | None | $141.25 | $141.25 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $104.71 | Professional | None | $53.70 | $75.86 | $104.71 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $83.18 Typical High $102.33 | Professional | None | $33.11 | $83.18 | $102.33 |
Providence Setting Facility Modifier None Typical Low $44.67 Median $83.18 Typical High $147.91 | Facility | None | $44.67 | $83.18 | $147.91 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $109.65 | Professional | None | $54.95 | $77.62 | $109.65 |
United Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $114.82 | Professional | None | $56.23 | $77.62 | $114.82 |
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 $19.95 Median $27.54 Typical High $33.11 | Professional | 52 · Reduced service | $19.95 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $8.32 Typical High $9.77 | Professional | 55 · Aftercare only | $6.03 | $8.32 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.50 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.98 | $5.50 | $6.61 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $61.66 Median $72.44 Typical High $87.10 | Professional | 25 · Same-day visit | $61.66 | $72.44 | $87.10 |
Where New Mexico sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 22nd 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.