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 $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $416.87 | Professional | None | $331.13 | $416.87 | $416.87 |
BCBS New Mexico Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $426.58 | Professional | None | $288.40 | $288.40 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $660.69 | Facility | None | $331.13 | $331.13 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Molina Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $588.84 | Professional | None | $309.03 | $398.11 | $588.84 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $660.69 | Facility | None | $331.13 | $331.13 | $660.69 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $165.96 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $165.96 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $48.98 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $41.69 | $41.69 |
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· 25th of 51
$331
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.