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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $69.18 | Professional | None | $54.95 | $69.18 | $69.18 |
BCBS New Mexico Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $72.44 | Professional | None | $29.51 | $29.51 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $109.65 | Facility | None | $54.95 | $54.95 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $125.89 | Professional | None | $72.44 | $83.18 | $125.89 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $109.65 | Facility | None | $54.95 | $54.95 | $109.65 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
United Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
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 $27.54 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $27.54 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $10.96 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $8.32 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.50 | $6.92 | $6.92 |
Where New Mexico sits
Rates are fairly even across states for this service. 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· 48th of 51
$54.95
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.