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 $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $24.55 | Professional | None | $21.38 | $21.38 | $24.55 |
BCBS New Mexico Setting Professional Modifier None Typical Low $10.47 Median $17.38 Typical High $38.02 | Professional | None | $10.47 | $17.38 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $33.11 | Professional | None | $27.54 | $27.54 | $33.11 |
Providence Setting Facility Modifier None Typical Low $12.30 Median $16.98 Typical High $17.38 | Facility | None | $12.30 | $16.98 | $17.38 |
Providence Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $51.29 | Professional | None | $23.99 | $23.99 | $51.29 |
United Setting Professional Modifier None Typical Low $15.85 Median $29.51 Typical High $47.86 | Professional | None | $15.85 | $29.51 | $47.86 |
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 $10.72 Median $10.72 Typical High $12.30 | Professional | 52 · Reduced service | $10.72 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $4.90 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $3.63 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $2.45 |
Where New Mexico sits
The same service costs 4.1 times more in Wyoming than in Kentucky. 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· 34th of 51
$23.99
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.