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 $0.40 Median $0.40 Typical High $0.40 | Facility | None | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.39 Typical High $0.40 | Professional | None | $0.32 | $0.39 | $0.40 |
BCBS New Mexico Setting Facility Modifier None Typical Low $0.43 Median $2.88 Typical High $6.46 | Facility | None | $0.43 | $2.88 | $6.46 |
BCBS New Mexico Setting Professional Modifier None Typical Low $0.32 Median $0.43 Typical High $0.52 | Professional | None | $0.32 | $0.43 | $0.52 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Molina Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.41 | Professional | None | $0.79 | $0.79 | $1.41 |
Providence Setting Facility Modifier None Typical Low $0.41 Median $0.45 Typical High $0.45 | Facility | None | $0.41 | $0.45 | $0.45 |
Providence Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.60 | Professional | None | $0.28 | $0.28 | $0.60 |
United Setting Professional Modifier None Typical Low $0.22 Median $0.23 Typical High $0.37 | Professional | None | $0.22 | $0.23 | $0.37 |
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 $0.16 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.16 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.06 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.05 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Where New Mexico sits
The same service costs 2.6 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· 23rd of 51
$0.39
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.