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 $1.78 Median $1.78 Typical High $1.78 | Facility | None | $1.78 | $1.78 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.74 Typical High $1.78 | Professional | None | $1.62 | $1.74 | $1.78 |
BCBS New Mexico Setting Facility Modifier None Typical Low $53.70 Median $58.88 Typical High $64.57 | Facility | None | $53.70 | $58.88 | $64.57 |
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 $1.02 Median $1.02 Typical High $1.12 | Professional | None | $1.02 | $1.02 | $1.12 |
Molina Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $5.25 | Professional | None | $2.45 | $2.45 | $5.25 |
Providence Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $2.14 | Professional | None | $1.02 | $1.12 | $2.14 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.05 Typical High $1.66 | Professional | None | $1.00 | $1.05 | $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 $0.81 Median $0.87 Typical High $0.89 | Professional | 52 · Reduced service | $0.81 | $0.87 | $0.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.35 Typical High $0.36 | Professional | 53 · Discontinued | $0.32 | $0.35 | $0.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.26 Typical High $0.27 | Professional | 55 · Aftercare only | $0.24 | $0.26 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.17 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.16 | $0.17 | $0.18 |
Where New Mexico sits
The same service costs 4.6 times more in Rhode Island 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· 30th of 51
$1.48
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.