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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $263.03 | Professional | None | $204.17 | $263.03 | $263.03 |
BCBS New Mexico Setting Facility Modifier None Typical Low $288.40 Median $1,023.29 Typical High $1,621.81 | Facility | None | $288.40 | $1,023.29 | $1,621.81 |
BCBS New Mexico Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $194.98 | Professional | None | $181.97 | $181.97 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $407.38 | Facility | None | $204.17 | $204.17 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $371.54 | Professional | None | $194.98 | $245.47 | $371.54 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $407.38 | Facility | None | $204.17 | $204.17 | $407.38 |
Providence Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $102.33 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $102.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $40.74 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $30.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $20.42 | $26.30 | $26.30 |
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· 39th of 51
$204
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.