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 $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $10.47 Typical High $10.47 | Professional | None | $8.13 | $10.47 | $10.47 |
BCBS New Mexico Setting Facility Modifier None Typical Low $33.11 Median $34.67 Typical High $89.13 | Facility | None | $33.11 | $34.67 | $89.13 |
BCBS New Mexico Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.50 | Professional | None | $19.05 | $19.05 | $19.50 |
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 $11.22 Median $11.22 Typical High $16.98 | Professional | None | $11.22 | $11.22 | $16.98 |
Providence Setting Facility Modifier None Typical Low $8.13 Median $37.15 Typical High $46.77 | Facility | None | $8.13 | $37.15 | $46.77 |
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 Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
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 $5.25 Typical High $5.25 | Professional | 52 · Reduced service | $4.07 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $2.09 Typical High $2.09 | Professional | 53 · Discontinued | $1.62 | $2.09 | $2.09 |
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 $1.05 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.81 | $1.05 | $1.05 |
Where New Mexico sits
The same service costs 1.9 times more in Wyoming than in Georgia. 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· 25th of 51
$8.71
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.