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 $38.90 Median $38.90 Typical High $51.29 | Facility | None | $38.90 | $38.90 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $54.95 Typical High $70.79 | Professional | None | $39.81 | $54.95 | $70.79 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $63.10 | Professional | None | $41.69 | $51.29 | $63.10 |
BCBS New Mexico Setting Professional Modifier None Typical Low $17.38 Median $46.77 Typical High $60.26 | Professional | None | $17.38 | $46.77 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $93.33 | Professional | None | $48.98 | $70.79 | $93.33 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $89.13 | Professional | None | $53.70 | $61.66 | $89.13 |
Providence Setting Facility Modifier None Typical Low $41.69 Median $66.07 Typical High $85.11 | Facility | None | $41.69 | $66.07 | $85.11 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $97.72 | Professional | None | $48.98 | $70.79 | $97.72 |
United Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $102.33 | Professional | None | $56.23 | $77.62 | $102.33 |
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 $19.95 Median $27.54 Typical High $35.48 | Professional | 52 · Reduced service | $19.95 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $8.32 Typical High $10.47 | Professional | 55 · Aftercare only | $6.03 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.50 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.98 | $5.50 | $7.08 |
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· 28th of 51
$60.26
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.