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 $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $41.69 | Professional | None | $32.36 | $41.69 | $41.69 |
BCBS New Mexico Setting Facility Modifier None Typical Low $48.98 Median $173.78 Typical High $269.15 | Facility | None | $48.98 | $173.78 | $269.15 |
BCBS New Mexico Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $42.66 | Professional | None | $31.62 | $31.62 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $64.57 | Facility | None | $32.36 | $32.36 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $38.90 Typical High $58.88 | Professional | None | $32.36 | $38.90 | $58.88 |
Providence Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $64.57 | Facility | None | $32.36 | $32.36 | $64.57 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
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 $16.22 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $16.22 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $6.46 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $4.90 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.24 | $4.17 | $4.17 |
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· 32nd of 51
$32.36
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.