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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | None | $33.88 | $43.65 | $43.65 |
BCBS New Mexico Setting Facility Modifier None Typical Low $97.72 Median $165.96 Typical High $338.84 | Facility | None | $97.72 | $165.96 | $338.84 |
BCBS New Mexico Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $25.70 | Professional | None | $23.99 | $23.99 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $67.61 | Facility | None | $33.88 | $33.88 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Providence Setting Facility Modifier None Typical Low $16.98 Median $21.38 Typical High $67.61 | Facility | None | $16.98 | $21.38 | $67.61 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
United Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
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 $16.98 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $16.98 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $6.76 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.13 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.39 | $4.37 | $4.37 |
Where New Mexico sits
The same service costs 5.4 times more in Wyoming than in Arizona. 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· 30th of 51
$33.88
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.