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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | None | $281.84 | $354.81 | $354.81 |
BCBS New Mexico Setting Facility Modifier None Typical Low $173.78 Median $602.56 Typical High $954.99 | Facility | None | $173.78 | $602.56 | $954.99 |
BCBS New Mexico Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | None | $213.80 | $213.80 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $562.34 | Facility | None | $281.84 | $281.84 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $371.54 | Professional | None | $251.19 | $251.19 | $371.54 |
Providence Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $562.34 | Facility | None | $281.84 | $281.84 | $562.34 |
Providence Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $138.04 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $56.23 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $28.18 | $35.48 | $35.48 |
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· 14th of 51
$282
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.