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 $1.78 Median $1.78 Typical High $1.78 | Facility | None | $1.78 | $1.78 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $1.05 Median $1.74 Typical High $1.78 | Professional | None | $1.05 | $1.74 | $1.78 |
Ambetter Setting Professional Modifier None Typical Low $1.86 Median $2.95 Typical High $3.47 | Professional | None | $1.86 | $2.95 | $3.47 |
BCBS New Mexico Setting Facility Modifier None Typical Low $5.37 Median $18.62 Typical High $29.51 | Facility | None | $5.37 | $18.62 | $29.51 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1.48 Median $1.95 Typical High $2.34 | Professional | None | $1.48 | $1.95 | $2.34 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Molina Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $6.31 | Professional | None | $3.63 | $3.63 | $6.31 |
Providence Setting Facility Modifier None Typical Low $1.74 Median $1.95 Typical High $1.95 | Facility | None | $1.74 | $1.95 | $1.95 |
Providence Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $2.69 | Professional | None | $1.26 | $1.26 | $2.69 |
United Setting Professional Modifier None Typical Low $0.95 Median $1.05 Typical High $1.55 | Professional | None | $0.95 | $1.05 | $1.55 |
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 $0.74 Median $0.87 Typical High $0.89 | Professional | 52 · Reduced service | $0.74 | $0.87 | $0.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.35 Typical High $0.36 | Professional | 53 · Discontinued | $0.28 | $0.35 | $0.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.26 Typical High $0.27 | Professional | 55 · Aftercare only | $0.22 | $0.26 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.17 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.15 | $0.17 | $0.18 |
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· 20th of 51
$1.74
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.