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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $23.44 Typical High $23.44 | Professional | None | $18.62 | $23.44 | $23.44 |
BCBS New Mexico Setting Facility Modifier None Typical Low $72.44 Median $74.13 Typical High $190.55 | Facility | None | $72.44 | $74.13 | $190.55 |
BCBS New Mexico Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $46.77 | Professional | None | $45.71 | $45.71 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $37.15 | Facility | None | $18.62 | $18.62 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $64.57 | Professional | None | $33.11 | $42.66 | $64.57 |
Providence Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $37.15 | Facility | None | $18.62 | $18.62 | $37.15 |
Providence Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
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 $9.33 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $9.33 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $3.72 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $2.75 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.86 | $2.34 | $2.34 |
Where New Mexico sits
The same service costs 1.8 times more in Hawaii than in Ohio. 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· 47th of 51
$18.62
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.