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 $0.65 Median $0.65 Typical High $0.65 | Facility | None | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier None Typical Low $0.38 Median $0.62 Typical High $0.65 | Professional | None | $0.38 | $0.62 | $0.65 |
BCBS New Mexico Setting Facility Modifier None Typical Low $1.32 Median $4.57 Typical High $7.24 | Facility | None | $1.32 | $4.57 | $7.24 |
BCBS New Mexico Setting Professional Modifier None Typical Low $0.52 Median $0.71 Typical High $0.83 | Professional | None | $0.52 | $0.71 | $0.83 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Molina Setting Professional Modifier None Typical Low $0.87 Median $0.87 Typical High $1.55 | Professional | None | $0.87 | $0.87 | $1.55 |
Providence Setting Facility Modifier None Typical Low $0.62 Median $0.68 Typical High $0.68 | Facility | None | $0.62 | $0.68 | $0.68 |
Providence Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.95 | Professional | None | $0.45 | $0.45 | $0.95 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.37 Typical High $0.54 | Professional | None | $0.34 | $0.37 | $0.54 |
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 $0.27 Median $0.31 Typical High $0.32 | Professional | 52 · Reduced service | $0.27 | $0.31 | $0.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.12 Typical High $0.13 | Professional | 53 · Discontinued | $0.11 | $0.12 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.09 Typical High $0.10 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.06 |
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
$0.58
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.