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 $75.86 Median $75.86 Typical High $102.33 | Facility | None | $75.86 | $75.86 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $141.25 | Professional | None | $85.11 | $107.15 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $134.90 | Professional | None | $109.65 | $128.82 | $134.90 |
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 $87.10 Median $120.23 Typical High $173.78 | Professional | None | $87.10 | $120.23 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $177.83 | Professional | None | $85.11 | $123.03 | $177.83 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $181.97 | Professional | None | $109.65 | $128.82 | $181.97 |
Providence Setting Facility Modifier None Typical Low $77.62 Median $128.82 Typical High $144.54 | Facility | None | $77.62 | $128.82 | $144.54 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $186.21 | Professional | None | $85.11 | $123.03 | $186.21 |
United Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $204.17 | Professional | None | $102.33 | $144.54 | $204.17 |
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 $38.90 Median $53.70 Typical High $70.79 | Professional | 52 · Reduced service | $38.90 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $16.22 Typical High $21.38 | Professional | 55 · Aftercare only | $11.75 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.72 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.76 | $10.72 | $14.45 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $109.65 Median $131.83 Typical High $144.54 | Professional | 25 · Same-day visit | $109.65 | $131.83 | $144.54 |
Where New Mexico sits
The same service costs 2.7 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· 27th of 51
$123
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.