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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $36.31 Typical High $37.15 | Professional | None | $34.67 | $36.31 | $37.15 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
BCBS New Mexico Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | None | $30.90 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $151.36 | Facility | None | $79.43 | $79.43 | $151.36 |
Providence Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $56.23 | Professional | None | $21.38 | $21.38 | $56.23 |
United Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $37.15 | Professional | None | $21.88 | $21.88 | $37.15 |
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 $16.98 Median $18.20 Typical High $18.62 | Professional | 52 · Reduced service | $16.98 | $18.20 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.24 Typical High $7.41 | Professional | 53 · Discontinued | $6.76 | $7.24 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $27.54 Typical High $28.18 | Professional | 54 · Surgery only | $25.12 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.50 Typical High $5.62 | Professional | 55 · Aftercare only | $5.13 | $5.50 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.63 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.39 | $3.63 | $3.72 |
Where New Mexico sits
The same service costs 2.6 times more in Hawaii than in New York. 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
$30.90
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.