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 $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.57 Typical High $2.57 | Professional | None | $2.04 | $2.57 | $2.57 |
Ambetter Setting Professional Modifier None Typical Low $1.74 Median $2.04 Typical High $2.04 | Professional | None | $1.74 | $2.04 | $2.04 |
BCBS New Mexico Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Professional | None | $2.34 | $2.34 | $2.51 |
Molina Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $3.39 | Professional | None | $2.24 | $2.24 | $3.39 |
Providence Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $2.09 | Facility | None | $1.86 | $1.86 | $2.09 |
Providence Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $3.89 | Professional | None | $2.82 | $2.82 | $3.89 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
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 $1.00 Median $1.29 Typical High $1.29 | Professional | 52 · Reduced service | $1.00 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.51 Typical High $0.51 | Professional | 53 · Discontinued | $0.40 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.39 Typical High $0.39 | Professional | 55 · Aftercare only | $0.30 | $0.39 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.20 | $0.26 | $0.26 |
Where New Mexico sits
The same service costs 2.1 times more in Wyoming than in Delaware. 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· 11th of 51
$2.24
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.