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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $1,071.52 Typical High $1,230.27 | Professional | None | $29.51 | $1,071.52 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
BCBS New Mexico Setting Professional Modifier None Typical Low $25.70 Median $741.31 Typical High $1,071.52 | Professional | None | $25.70 | $741.31 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,548.82 | Professional | None | $33.11 | $33.11 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $30.90 Median $1,071.52 Typical High $1,258.93 | Facility | None | $30.90 | $1,071.52 | $1,258.93 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $1,258.93 Typical High $2,511.89 | Professional | None | $95.50 | $1,258.93 | $2,511.89 |
United Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $7,079.46 | Facility | None | $3,162.28 | $3,162.28 | $7,079.46 |
United Setting Professional Modifier None Typical Low $31.62 Median $831.76 Typical High $1,698.24 | Professional | None | $31.62 | $831.76 | $1,698.24 |
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 $512.86 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $512.86 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $120.23 |
Where New Mexico sits
The same service costs 49.0 times more in Hawaii than in Maryland. 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· 42nd of 51
$851
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.