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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | None | $36.31 | $46.77 | $46.77 |
BCBS New Mexico Setting Facility Modifier None Typical Low $54.95 Median $190.55 Typical High $302.00 | Facility | None | $54.95 | $190.55 | $302.00 |
BCBS New Mexico Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Professional | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $74.13 | Facility | None | $36.31 | $36.31 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $66.07 | Professional | None | $36.31 | $43.65 | $66.07 |
Providence Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $74.13 | Facility | None | $36.31 | $36.31 | $74.13 |
Providence Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
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 $18.20 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $18.20 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $7.41 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $5.50 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.63 | $4.68 | $4.68 |
Ambetter Setting Professional Modifier JW · Drug discarded + JZ · No drug discarded Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | JW · Drug discarded + JZ · No drug discarded | $36.31 | $36.31 | $36.31 |
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· 32nd of 51
$36.31
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.