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 $162.18 Median $204.17 Typical High $295.12 | Facility | None | $162.18 | $204.17 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $223.87 | Professional | None | $162.18 | $204.17 | $223.87 |
BCBS New Mexico Setting Facility Modifier None Typical Low $338.84 Median $1,174.90 Typical High $1,737.80 | Facility | None | $338.84 | $1,174.90 | $1,737.80 |
BCBS New Mexico Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $190.55 | Professional | None | $141.25 | $173.78 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $323.59 | Facility | None | $162.18 | $162.18 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $269.15 | Professional | None | $181.97 | $181.97 | $269.15 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $501.19 | Facility | None | $162.18 | $288.40 | $501.19 |
Providence Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
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 $79.43 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $79.43 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $32.36 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $23.99 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.85 | $20.42 | $20.42 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | JZ · No drug discarded | $177.83 | $177.83 | $177.83 |
Where New Mexico sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 28th of 51
$174
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.