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 $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $5.50 Typical High $5.50 | Professional | None | $4.27 | $5.50 | $5.50 |
BCBS New Mexico Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.59 | Professional | None | $7.41 | $7.41 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $8.51 | Facility | None | $4.27 | $4.27 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Molina Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $9.12 | Professional | None | $6.46 | $6.46 | $9.12 |
Providence Setting Facility Modifier None Typical Low $4.27 Median $21.38 Typical High $22.39 | Facility | None | $4.27 | $21.38 | $22.39 |
Providence Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
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 $2.14 Median $2.75 Typical High $2.75 | Professional | 52 · Reduced service | $2.14 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $1.10 Typical High $1.10 | Professional | 53 · Discontinued | $0.85 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.81 Typical High $0.81 | Professional | 55 · Aftercare only | $0.65 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.43 | $0.55 | $0.55 |
Where New Mexico sits
The same service costs 5.1 times more in Wyoming than in Alabama. 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· 23rd of 51
$4.68
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.