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 $8.13 Median $10.23 Typical High $15.14 | Facility | None | $8.13 | $10.23 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $10.23 Typical High $10.23 | Professional | None | $8.13 | $10.23 | $10.23 |
BCBS New Mexico Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $9.55 | Professional | None | $2.14 | $2.14 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $16.22 | Facility | None | $8.13 | $8.13 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Molina Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $3.39 | Professional | None | $2.29 | $2.29 | $3.39 |
Providence Setting Facility Modifier None Typical Low $1.26 Median $1.41 Typical High $16.22 | Facility | None | $1.26 | $1.41 | $16.22 |
Providence Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
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 $4.07 Median $5.13 Typical High $5.13 | Professional | 52 · Reduced service | $4.07 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $2.04 Typical High $2.04 | Professional | 53 · Discontinued | $1.62 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.55 Typical High $1.55 | Professional | 55 · Aftercare only | $1.23 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $1.02 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.81 | $1.02 | $1.02 |
Where New Mexico sits
Rates are fairly even across states for this service. 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· 40th of 51
$8.13
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.