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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $45.71 | Professional | None | $30.90 | $41.69 | $45.71 |
BCBS New Mexico Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $61.66 | Professional | None | $35.48 | $47.86 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $123.03 | Professional | None | $87.10 | $87.10 | $123.03 |
Providence Setting Facility Modifier None Typical Low $34.67 Median $40.74 Typical High $85.11 | Facility | None | $34.67 | $40.74 | $85.11 |
Providence Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $56.23 | Professional | None | $34.67 | $34.67 | $56.23 |
United Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $77.62 | Professional | None | $30.20 | $30.20 | $77.62 |
2 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 55 · Aftercare only Typical Low $4.57 Median $6.17 Typical High $6.76 | Professional | 55 · Aftercare only | $4.57 | $6.17 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.17 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.09 | $4.17 | $4.57 |
Where New Mexico sits
The same service costs 2.6 times more in Wyoming than in Kentucky. 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· 28th of 51
$41.69
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.