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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $31.62 Typical High $31.62 | Professional | None | $25.12 | $31.62 | $31.62 |
BCBS New Mexico Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | None | $24.55 | $24.55 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $50.12 | Facility | None | $25.12 | $25.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $31.62 | Professional | None | $20.89 | $20.89 | $31.62 |
Providence Setting Facility Modifier None Typical Low $25.12 Median $41.69 Typical High $147.91 | Facility | None | $25.12 | $41.69 | $147.91 |
Providence Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
United Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
5 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 $12.30 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $12.30 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $5.01 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $3.72 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.45 | $3.16 | $3.16 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $16.60 Median $25.12 Typical High $25.12 | Professional | JZ · No drug discarded | $16.60 | $25.12 | $25.12 |
Where New Mexico sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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
$25.12
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.