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 $100.00 Median $100.00 Typical High $128.82 | Facility | None | $100.00 | $100.00 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $177.83 | Professional | None | $112.20 | $141.25 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $165.96 | Professional | None | $138.04 | $162.18 | $165.96 |
BCBS New Mexico Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $173.78 | Professional | None | $102.33 | $151.36 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $234.42 | Professional | None | $112.20 | $158.49 | $234.42 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $229.09 | Professional | None | $138.04 | $162.18 | $229.09 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $162.18 Typical High $186.21 | Facility | None | $102.33 | $162.18 | $186.21 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $234.42 | Professional | None | $109.65 | $158.49 | $234.42 |
United Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $257.04 | Professional | None | $131.83 | $190.55 | $257.04 |
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 $51.29 Median $70.79 Typical High $89.13 | Professional | 52 · Reduced service | $51.29 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.89 Typical High $26.92 | Professional | 55 · Aftercare only | $15.14 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.13 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.23 | $14.13 | $17.78 |
Where New Mexico sits
The same service costs 2.6 times more in Alaska than in Florida. 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
$155
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.