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 $54.95 Median $54.95 Typical High $77.62 | Facility | None | $54.95 | $54.95 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $107.15 | Professional | None | $57.54 | $77.62 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $104.71 | Professional | None | $85.11 | $100.00 | $104.71 |
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 $61.66 Median $91.20 Typical High $102.33 | Professional | None | $61.66 | $91.20 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $131.83 | Professional | None | $58.88 | $89.13 | $131.83 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $138.04 | Professional | None | $83.18 | $97.72 | $138.04 |
Providence Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $97.72 | Facility | None | $51.29 | $95.50 | $97.72 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $141.25 | Professional | None | $58.88 | $89.13 | $141.25 |
United Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $151.36 | Professional | None | $69.18 | $102.33 | $151.36 |
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 $27.54 Median $38.02 Typical High $53.70 | Professional | 52 · Reduced service | $27.54 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $11.48 Typical High $16.22 | Professional | 55 · Aftercare only | $8.32 | $11.48 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.59 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.50 | $7.59 | $10.72 |
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· 27th of 51
$91.20
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.