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 $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $5.89 Typical High $6.03 | Professional | None | $3.63 | $5.89 | $6.03 |
BCBS New Mexico Setting Facility Modifier None Typical Low $12.30 Median $42.66 Typical High $67.61 | Facility | None | $12.30 | $42.66 | $67.61 |
BCBS New Mexico Setting Professional Modifier None Typical Low $4.90 Median $6.61 Typical High $7.76 | Professional | None | $4.90 | $6.61 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Molina Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $14.45 | Professional | None | $8.32 | $8.32 | $14.45 |
Providence Setting Facility Modifier None Typical Low $5.89 Median $6.46 Typical High $6.46 | Facility | None | $5.89 | $6.46 | $6.46 |
Providence Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $9.12 | Professional | None | $4.27 | $4.27 | $9.12 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $5.25 | Professional | None | $3.24 | $3.47 | $5.25 |
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 $2.45 Median $2.95 Typical High $3.02 | Professional | 52 · Reduced service | $2.45 | $2.95 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.17 Typical High $1.20 | Professional | 53 · Discontinued | $1.00 | $1.17 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.74 Median $0.87 Typical High $0.89 | Professional | 55 · Aftercare only | $0.74 | $0.87 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.59 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.49 | $0.59 | $0.60 |
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· 22nd of 51
$5.25
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.