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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $263.03 | Professional | None | $190.55 | $239.88 | $263.03 |
BCBS New Mexico Setting Facility Modifier None Typical Low $204.17 Median $724.44 Typical High $1,122.02 | Facility | None | $204.17 | $724.44 | $1,122.02 |
BCBS New Mexico Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | None | $165.96 | $165.96 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $380.19 | Facility | None | $190.55 | $190.55 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $190.55 Median $190.55 Typical High $380.19 | Facility | None | $190.55 | $190.55 | $380.19 |
Providence Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $95.50 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $95.50 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $38.02 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.05 | $23.99 | $23.99 |
Ambetter Setting Professional Modifier JW · Drug discarded + JZ · No drug discarded Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | JW · Drug discarded + JZ · No drug discarded | $186.21 | $186.21 | $186.21 |
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· 17th of 51
$191
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.