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 $57.54 Median $57.54 Typical High $69.18 | Facility | None | $57.54 | $57.54 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $95.50 | Professional | None | $58.88 | $81.28 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $91.20 | Professional | None | $85.11 | $85.11 | $91.20 |
BCBS New Mexico Setting Professional Modifier None Typical Low $19.05 Median $69.18 Typical High $85.11 | Professional | None | $19.05 | $69.18 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $134.90 | Professional | None | $67.61 | $97.72 | $134.90 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $123.03 | Professional | None | $74.13 | $85.11 | $123.03 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $93.33 Typical High $117.49 | Facility | None | $61.66 | $93.33 | $117.49 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $138.04 | Professional | None | $67.61 | $100.00 | $138.04 |
United Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $141.25 | Professional | None | $81.28 | $112.20 | $141.25 |
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 $29.51 Median $40.74 Typical High $47.86 | Professional | 52 · Reduced service | $29.51 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.02 Typical High $14.45 | Professional | 55 · Aftercare only | $8.91 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.13 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.03 | $8.13 | $9.55 |
Where New Mexico sits
The same service costs 2.9 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· 31st of 51
$85.11
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.