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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $30.90 Typical High $31.62 | Professional | None | $18.62 | $30.90 | $31.62 |
BCBS New Mexico Setting Facility Modifier None Typical Low $64.57 Median $223.87 Typical High $354.81 | Facility | None | $64.57 | $223.87 | $354.81 |
BCBS New Mexico Setting Professional Modifier None Typical Low $25.70 Median $34.67 Typical High $40.74 | Professional | None | $25.70 | $34.67 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $64.57 | Professional | None | $43.65 | $43.65 | $64.57 |
Providence Setting Facility Modifier None Typical Low $30.90 Median $33.88 Typical High $33.88 | Facility | None | $30.90 | $33.88 | $33.88 |
Providence Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $47.86 | Professional | None | $21.88 | $21.88 | $47.86 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
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 $12.88 Median $15.49 Typical High $15.85 | Professional | 52 · Reduced service | $12.88 | $15.49 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.17 Typical High $6.31 | Professional | 53 · Discontinued | $5.25 | $6.17 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.57 Typical High $4.68 | Professional | 55 · Aftercare only | $3.89 | $4.57 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.09 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.57 | $3.09 | $3.16 |
Where New Mexico sits
The same service costs 3.2 times more in Hawaii than in Utah. 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
$30.90
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.