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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $72.44 | Professional | None | $57.54 | $72.44 | $72.44 |
BCBS New Mexico Setting Facility Modifier None Typical Low $66.07 Median $234.42 Typical High $363.08 | Facility | None | $66.07 | $234.42 | $363.08 |
BCBS New Mexico Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $51.29 | Professional | None | $47.86 | $47.86 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $114.82 | Facility | None | $57.54 | $57.54 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $102.33 | Professional | None | $51.29 | $60.26 | $102.33 |
Providence Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $114.82 | Facility | None | $57.54 | $57.54 | $114.82 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $28.84 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $28.84 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $11.48 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $8.51 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.75 | $7.24 | $7.24 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | JZ · No drug discarded | $57.54 | $57.54 | $57.54 |
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· 27th of 51
$57.54
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.