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 $0.27 Median $0.27 Typical High $0.27 | Facility | None | $0.27 | $0.27 | $0.27 |
Aetna Setting Professional Modifier None Typical Low $0.19 Median $0.25 Typical High $0.27 | Professional | None | $0.19 | $0.25 | $0.27 |
BCBS New Mexico Setting Facility Modifier None Typical Low $0.65 Median $0.71 Typical High $0.78 | Facility | None | $0.65 | $0.71 | $0.78 |
BCBS New Mexico Setting Professional Modifier None Typical Low $0.08 Median $0.11 Typical High $0.12 | Professional | None | $0.08 | $0.11 | $0.12 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
Molina Setting Professional Modifier None Typical Low $0.11 Median $0.15 Typical High $0.23 | Professional | None | $0.11 | $0.15 | $0.23 |
Providence Setting Facility Modifier None Typical Low $0.12 Median $0.42 Typical High $0.47 | Facility | None | $0.12 | $0.42 | $0.47 |
Providence Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.11 | Professional | None | $0.06 | $0.06 | $0.11 |
United Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.10 | Professional | None | $0.06 | $0.06 | $0.10 |
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 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier AW · With surgical dressing Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | AW · With surgical dressing | $0.04 | $0.04 | $0.04 |
Where New Mexico sits
The same service costs 6.0 times more in Minnesota than in Wyoming. 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· 19th of 51
$0.11
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.