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 $0.56 Median $0.56 Typical High $0.56 | Facility | None | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.72 Typical High $0.72 | Professional | None | $0.56 | $0.72 | $0.72 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.35 | Professional | None | $1.29 | $1.29 | $1.35 |
Cigna Setting Facility Modifier None Typical Low $0.55 Median $0.55 Typical High $1.10 | Facility | None | $0.55 | $0.55 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Molina Setting Professional Modifier None Typical Low $0.59 Median $0.59 Typical High $0.89 | Professional | None | $0.59 | $0.59 | $0.89 |
Providence Setting Facility Modifier None Typical Low $0.55 Median $0.55 Typical High $1.10 | Facility | None | $0.55 | $0.55 | $1.10 |
Providence Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
3 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 $0.09 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.09 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.07 | $0.07 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | JZ · No drug discarded | $2.00 | $2.00 | $2.00 |
Where New Mexico sits
The same service costs 1.9 times more in Wyoming than in Oklahoma. 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· 23rd of 51
$0.59
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.