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 $58.88 Median $58.88 Typical High $87.10 | Facility | None | $58.88 | $58.88 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $117.49 | Professional | None | $63.10 | $85.11 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $138.04 | Professional | None | $93.33 | $109.65 | $138.04 |
BCBS New Mexico Setting Facility Modifier None Typical Low $169.82 Median $616.60 Typical High $933.25 | Facility | None | $169.82 | $616.60 | $933.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $173.78 | Professional | None | $69.18 | $102.33 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $151.36 | Professional | None | $69.18 | $104.71 | $151.36 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $181.97 | Professional | None | $107.15 | $125.89 | $181.97 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $109.65 Typical High $125.89 | Facility | None | $58.88 | $109.65 | $125.89 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $154.88 | Professional | None | $69.18 | $104.71 | $154.88 |
United Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $169.82 | Professional | None | $79.43 | $117.49 | $169.82 |
3 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 $30.20 Median $41.69 Typical High $58.88 | Professional | 52 · Reduced service | $30.20 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.59 Typical High $17.78 | Professional | 55 · Aftercare only | $9.12 | $12.59 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $11.75 |
Where New Mexico sits
The same service costs 2.9 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· 26th of 51
$105
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.