How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $12.02 Typical High $12.02 | Professional | None | $9.55 | $12.02 | $12.02 |
BCBS New Mexico Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $5.25 | Professional | None | $4.79 | $4.79 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $19.05 | Facility | None | $9.55 | $9.55 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Molina Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $12.59 | Professional | None | $8.32 | $8.32 | $12.59 |
Providence Setting Facility Modifier None Typical Low $8.51 Median $9.33 Typical High $19.05 | Facility | None | $8.51 | $9.33 | $19.05 |
Providence Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
5 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 $4.79 Median $6.03 Typical High $6.03 | Professional | 52 · Reduced service | $4.79 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $2.40 Typical High $2.40 | Professional | 53 · Discontinued | $1.91 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.45 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.95 | $1.20 | $1.20 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | JZ · No drug discarded | $8.13 | $8.13 | $8.13 |
Where New Mexico sits
The same service costs 1.7 times more in Wyoming than in North Carolina. 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· 20th of 51
$9.55
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.