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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $281.84 | Professional | None | $158.49 | $281.84 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | None | $100.00 | $100.00 | $117.49 |
BCBS New Mexico Setting Facility Modifier None Typical Low $269.15 Median $954.99 Typical High $1,479.11 | Facility | None | $269.15 | $954.99 | $1,479.11 |
BCBS New Mexico Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | None | $281.84 | $281.84 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $446.68 | Professional | None | $60.26 | $60.26 | $446.68 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
United Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $1,445.44 | Facility | None | $645.65 | $645.65 | $1,445.44 |
United Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $398.11 | Professional | None | $186.21 | $275.42 | $398.11 |
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 $83.18 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $83.18 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $33.11 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $24.55 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $16.60 | $28.18 | $28.18 |
Where New Mexico sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 15th of 51
$245
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.