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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $58.88 | Professional | None | $43.65 | $54.95 | $58.88 |
BCBS New Mexico Setting Facility Modifier None Typical Low $43.65 Median $158.49 Typical High $239.88 | Facility | None | $43.65 | $158.49 | $239.88 |
BCBS New Mexico Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $43.65 | Professional | None | $36.31 | $36.31 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $87.10 | Facility | None | $43.65 | $43.65 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $61.66 | Professional | None | $40.74 | $40.74 | $61.66 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $87.10 | Facility | None | $43.65 | $43.65 | $87.10 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
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 $21.88 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $21.88 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $8.71 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $6.61 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.37 | $5.50 | $5.50 |
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· 37th of 51
$43.65
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.