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 $1.17 Median $1.17 Typical High $1.17 | Facility | None | $1.17 | $1.17 | $1.17 |
Aetna Setting Professional Modifier None Typical Low $1.07 Median $1.15 Typical High $1.17 | Professional | None | $1.07 | $1.15 | $1.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.17 Typical High $0.18 | Professional | 55 · Aftercare only | $0.16 | $0.17 | $0.18 |
BCBS New Mexico Setting Professional Modifier None Typical Low $0.87 Median $1.15 Typical High $1.41 | Professional | None | $0.87 | $1.15 | $1.41 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Molina Setting Professional Modifier None Typical Low $1.48 Median $2.14 Typical High $2.14 | Professional | None | $1.48 | $2.14 | $2.14 |
Providence Setting Facility Modifier None Typical Low $12.02 Median $13.18 Typical High $14.13 | Facility | None | $12.02 | $13.18 | $14.13 |
Providence Setting Professional Modifier None Typical Low $0.78 Median $1.02 Typical High $1.02 | Professional | None | $0.78 | $1.02 | $1.02 |
United Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $11.48 | Professional | None | $0.85 | $0.85 | $11.48 |
1 more rate 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 56 · Pre-op care only Typical Low $0.10 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.10 | $0.12 | $0.12 |
Where New Mexico sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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· 38th of 51
$1.15
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.