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 $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.66 Typical High $1.66 | Professional | None | $1.32 | $1.66 | $1.66 |
BCBS New Mexico Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.82 | Professional | None | $1.78 | $1.78 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $2.57 | Facility | None | $1.29 | $1.29 | $2.57 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Molina Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.34 | Professional | None | $1.58 | $1.58 | $2.34 |
Providence Setting Facility Modifier None Typical Low $1.29 Median $8.91 Typical High $10.96 | Facility | None | $1.29 | $8.91 | $10.96 |
Providence Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
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 $0.66 Median $0.83 Typical High $0.83 | Professional | 52 · Reduced service | $0.66 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.33 Typical High $0.33 | Professional | 53 · Discontinued | $0.26 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.20 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.13 | $0.17 | $0.17 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | JZ · No drug discarded | $1.32 | $1.32 | $1.32 |
Where New Mexico sits
The same service costs 1.9 times more in Wyoming than in Florida. 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· 48th of 51
$1.32
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.