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 $1.29 Median $1.29 Typical High $1.29 | Facility | None | $1.29 | $1.29 | $1.29 |
Aetna Setting Professional Modifier None Typical Low $1.05 Median $1.26 Typical High $1.29 | Professional | None | $1.05 | $1.26 | $1.29 |
BCBS New Mexico Setting Facility Modifier None Typical Low $2.63 Median $9.12 Typical High $14.45 | Facility | None | $2.63 | $9.12 | $14.45 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1.05 Median $1.41 Typical High $1.66 | Professional | None | $1.05 | $1.41 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Molina Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $3.09 | Professional | None | $1.74 | $1.74 | $3.09 |
Providence Setting Facility Modifier None Typical Low $1.29 Median $1.41 Typical High $1.41 | Facility | None | $1.29 | $1.41 | $1.41 |
Providence Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $1.95 | Professional | None | $0.89 | $0.89 | $1.95 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.76 Typical High $1.12 | Professional | None | $0.71 | $0.76 | $1.12 |
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 $0.52 Median $0.63 Typical High $0.65 | Professional | 52 · Reduced service | $0.52 | $0.63 | $0.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.25 Typical High $0.26 | Professional | 53 · Discontinued | $0.21 | $0.25 | $0.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.19 Typical High $0.19 | Professional | 55 · Aftercare only | $0.15 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.10 | $0.13 | $0.13 |
Where New Mexico sits
The same service costs 2.5 times more in Idaho 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· 22nd of 51
$1.12
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.