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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $134.90 | Professional | None | $107.15 | $134.90 | $134.90 |
BCBS New Mexico Setting Facility Modifier None Typical Low $173.78 Median $630.96 Typical High $954.99 | Facility | None | $173.78 | $630.96 | $954.99 |
BCBS New Mexico Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $269.15 | Facility | None | $125.89 | $177.83 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $204.17 | Professional | None | $112.20 | $138.04 | $204.17 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $257.04 | Facility | None | $125.89 | $177.83 | $257.04 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $53.70 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $53.70 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $21.38 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $15.85 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.72 | $13.49 | $13.49 |
Where New Mexico sits
The same service costs 6.0 times more in Wyoming than in Montana. 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· 36th of 51
$126
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.