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 $1.91 Median $1.91 Typical High $1.91 | Facility | None | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.86 Typical High $1.91 | Professional | None | $1.58 | $1.86 | $1.91 |
BCBS New Mexico Setting Facility Modifier None Typical Low $5.75 Median $19.95 Typical High $31.62 | Facility | None | $5.75 | $19.95 | $31.62 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1.58 Median $2.09 Typical High $2.51 | Professional | None | $1.58 | $2.09 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Molina Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $6.76 | Professional | None | $3.80 | $3.80 | $6.76 |
Providence Setting Facility Modifier None Typical Low $1.86 Median $2.09 Typical High $2.09 | Facility | None | $1.86 | $2.09 | $2.09 |
Providence Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $2.88 | Professional | None | $1.32 | $1.32 | $2.88 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.66 | Professional | None | $1.02 | $1.12 | $1.66 |
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 $0.79 Median $0.93 Typical High $0.95 | Professional | 52 · Reduced service | $0.79 | $0.93 | $0.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.31 Median $0.37 Typical High $0.38 | Professional | 53 · Discontinued | $0.31 | $0.37 | $0.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.22 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.15 | $0.19 | $0.19 |
Where New Mexico sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 22nd of 51
$1.66
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.