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 $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $26.92 Typical High $26.92 | Professional | None | $20.89 | $26.92 | $26.92 |
BCBS New Mexico Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | None | $50.12 | $50.12 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $41.69 | Facility | None | $20.89 | $20.89 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $30.20 Typical High $45.71 | Professional | None | $26.30 | $30.20 | $45.71 |
Providence Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $41.69 | Facility | None | $20.89 | $20.89 | $41.69 |
Providence Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
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 $10.47 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $10.47 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $4.17 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $3.16 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.09 | $2.69 | $2.69 |
Where New Mexico sits
The same service costs 3.8 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· 46th of 51
$20.89
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.