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 $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.45 Typical High $2.51 | Professional | None | $2.04 | $2.45 | $2.51 |
BCBS New Mexico Setting Professional Modifier None Typical Low $2.00 Median $2.69 Typical High $3.31 | Professional | None | $2.00 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Molina Setting Professional Modifier None Typical Low $2.40 Median $3.47 Typical High $5.13 | Professional | None | $2.40 | $3.47 | $5.13 |
Providence Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $8.13 | Professional | None | $2.00 | $2.00 | $8.13 |
United Setting Professional Modifier None Typical Low $1.55 Median $1.70 Typical High $2.57 | Professional | None | $1.55 | $1.70 | $2.57 |
4 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 $1.02 Median $1.23 Typical High $1.26 | Professional | 52 · Reduced service | $1.02 | $1.23 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.49 Typical High $0.50 | Professional | 53 · Discontinued | $0.41 | $0.49 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.37 Typical High $0.37 | Professional | 55 · Aftercare only | $0.28 | $0.37 | $0.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.24 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.20 | $0.24 | $0.25 |
Where New Mexico sits
The same service costs 2.3 times more in Hawaii than in Kentucky. 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· 23rd of 51
$2.40
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.