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 $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $3.09 Typical High $3.16 | Professional | None | $1.62 | $3.09 | $3.16 |
BCBS New Mexico Setting Facility Modifier None Typical Low $9.55 Median $33.11 Typical High $53.70 | Facility | None | $9.55 | $33.11 | $53.70 |
BCBS New Mexico Setting Professional Modifier None Typical Low $2.57 Median $3.47 Typical High $4.17 | Professional | None | $2.57 | $3.47 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Molina Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $11.22 | Professional | None | $6.46 | $6.46 | $11.22 |
Providence Setting Facility Modifier None Typical Low $3.16 Median $3.47 Typical High $3.47 | Facility | None | $3.16 | $3.47 | $3.47 |
Providence Setting Professional Modifier None Typical Low $2.14 Median $2.24 Typical High $2.24 | Professional | None | $2.14 | $2.24 | $2.24 |
United Setting Professional Modifier None Typical Low $1.74 Median $1.86 Typical High $2.82 | Professional | None | $1.74 | $1.86 | $2.82 |
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 $1.23 Median $1.55 Typical High $1.58 | Professional | 52 · Reduced service | $1.23 | $1.55 | $1.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.62 Typical High $0.65 | Professional | 53 · Discontinued | $0.50 | $0.62 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.47 Typical High $0.48 | Professional | 55 · Aftercare only | $0.37 | $0.47 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.31 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.25 | $0.31 | $0.32 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Where New Mexico sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 17th of 51
$2.82
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.