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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | None | $144.54 | $181.97 | $181.97 |
BCBS New Mexico Setting Facility Modifier None Typical Low $199.53 Median $691.83 Typical High $1,096.48 | Facility | None | $199.53 | $691.83 | $1,096.48 |
BCBS New Mexico Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Professional | None | $117.49 | $117.49 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $288.40 | Facility | None | $144.54 | $144.54 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $257.04 | Professional | None | $131.83 | $173.78 | $257.04 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $288.40 | Facility | None | $144.54 | $144.54 | $288.40 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $72.44 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $72.44 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $28.84 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $21.38 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.45 | $18.20 | $18.20 |
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· 42nd of 51
$145
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.