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 $93.33 Median $93.33 Typical High $120.23 | Facility | None | $93.33 | $93.33 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $165.96 | Professional | None | $102.33 | $131.83 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $154.88 | Professional | None | $128.82 | $151.36 | $154.88 |
BCBS New Mexico Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $173.78 | Professional | None | $102.33 | $138.04 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $213.80 | Professional | None | $102.33 | $144.54 | $213.80 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $208.93 | Professional | None | $125.89 | $147.91 | $208.93 |
Providence Setting Facility Modifier None Typical Low $95.50 Median $151.36 Typical High $169.82 | Facility | None | $95.50 | $151.36 | $169.82 |
Providence Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $213.80 | Professional | None | $100.00 | $144.54 | $213.80 |
United Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $234.42 | Professional | None | $123.03 | $169.82 | $234.42 |
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 $47.86 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $47.86 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $14.13 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.18 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.55 | $13.18 | $16.60 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $125.89 Median $151.36 Typical High $165.96 | Professional | 25 · Same-day visit | $125.89 | $151.36 | $165.96 |
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· 25th 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.