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 $0.38 Median $0.38 Typical High $1.00 | Facility | None | $0.38 | $0.38 | $1.00 |
Aetna Setting Professional Modifier None Typical Low $0.19 Median $0.44 Typical High $0.44 | Professional | None | $0.19 | $0.44 | $0.44 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1.38 Median $4.79 Typical High $7.59 | Facility | None | $1.38 | $4.79 | $7.59 |
BCBS New Mexico Setting Professional Modifier None Typical Low $0.37 Median $0.50 Typical High $0.59 | Professional | None | $0.37 | $0.50 | $0.59 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Molina Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $1.62 | Professional | None | $0.91 | $0.91 | $1.62 |
Providence Setting Facility Modifier None Typical Low $0.45 Median $0.50 Typical High $0.50 | Facility | None | $0.45 | $0.50 | $0.50 |
Providence Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $1.45 | Professional | None | $0.31 | $0.31 | $1.45 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.26 Typical High $0.40 | Professional | None | $0.25 | $0.26 | $0.40 |
5 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 $0.18 Median $0.22 Typical High $0.22 | Professional | 52 · Reduced service | $0.18 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.07 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.05 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.04 Typical High $0.17 | Professional | RR · Rental | $0.04 | $0.04 | $0.17 |
Where New Mexico sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 21st of 51
$0.40
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.