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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $177.83 | Professional | None | $138.04 | $177.83 | $177.83 |
BCBS New Mexico Setting Facility Modifier None Typical Low $223.87 Median $758.58 Typical High $1,230.27 | Facility | None | $223.87 | $758.58 | $1,230.27 |
BCBS New Mexico Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $138.04 Median $138.04 Typical High $208.93 | Professional | None | $138.04 | $138.04 | $208.93 |
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 $69.18 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $69.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $27.54 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $20.89 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.80 | $17.78 | $17.78 |
Where New Mexico sits
The same service costs 2.2 times more in Alaska 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· 46th 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.