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 $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $21.88 Typical High $23.99 | Professional | None | $17.38 | $21.88 | $23.99 |
BCBS New Mexico Setting Facility Modifier None Typical Low $15.49 Median $54.95 Typical High $85.11 | Facility | None | $15.49 | $54.95 | $85.11 |
BCBS New Mexico Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $15.49 | Professional | None | $14.45 | $14.45 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $34.67 | Facility | None | $17.38 | $17.38 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $24.55 | Professional | None | $16.22 | $16.22 | $24.55 |
Providence Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $34.67 | Facility | None | $17.38 | $17.38 | $34.67 |
Providence Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
United Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
United Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
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 $8.51 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $8.51 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $3.47 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $2.57 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.74 | $2.19 | $2.19 |
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· 48th of 51
$17.38
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.